title: Outcome of singleton pregnancy in women ≥ 45 years old: a retrospective cohort study.
abstract: OBJECTIVE
  To investigate prematurity rate in women aged ≥ 45 carrying a singleton pregnancy. Other maternal and neonatal outcomes are also described.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Women delivering a singleton pregnancy at a single tertiary medical center.
  
  
  METHODS
  The study included all women aged 45 years and over who delivered at 20 weeks gestation or beyond over a 9-year period from May 2000 to May 2009.
  
  
  METHODS
  Women aged 45 years and over were identified. The study group was compared to a control group of women <40 years with singleton pregnancies conceived by in vitro fertilization (IVF) who delivered during the same time period.
  
  
  METHODS
  Maternal complications during pregnancy and neonatal outcome.
  
  
  RESULTS
  During the study period 278 women ≥ 45 years delivered a singleton pregnancy. The control group included 304 women. The rate of delivery before 37 weeks as well as before 32 weeks were very high in our study group (18.7 vs. 10.9%, p = 0.009 and 5.4 vs. 2.0%, p = 0.04, respectively). In multivariate analysis, older maternal age was not independently related to prematurity. Chronic hypertension (HTN) was found to be a major risk factor associated with prematurity in advanced maternal age.
  
  
  CONCLUSIONS
  Women ≥ 45-years-old with a singleton pregnancy carry a higher risk of maternal and perinatal complications. Preterm birth is a significant complication in this age group and is associated with preexisting chronic HTN.
authors.affiliation: Department of Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Ido
authors.initials: I
authors.lastname: Laskov
authors.forename: Roee
authors.initials: R
authors.lastname: Birnbaum
authors.forename: Sharon
authors.initials: S
authors.lastname: Maslovitz
authors.forename: Michael
authors.initials: M
authors.lastname: Kupferminc
authors.forename: Joseph
authors.initials: J
authors.lastname: Lessing
authors.forename: Ariel
authors.initials: A
authors.lastname: Many
mesh_terms: D000328:Adult; D000367:Age Factors; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D005307:Fertilization in Vitro / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D008423:Maternal Age; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012189:Retrospective Studies