title: Pregnancy outcomes in women greater than 45 years: a cohort control study in a multi-ethnic inner city population.
abstract: OBJECTIVE
  To examine the pregnancy outcomes of women >45 years in a multi-ethnic population when compared to controls and to reflect on socio-demographic details of the older mothers.
  
  
  METHODS
  A retrospective cohort control study over an 8-year period in an inner city London hospital with multi-ethnic population. The influence of advanced maternal age (>45 years at time of delivery) on fetal and maternal outcomes was assessed by comparing these women to controls (aged 20-30 years) matched for ethnicity, country of origin and parity.
  
  
  RESULTS
  Data from 64 cases and 64 controls were compared. Ninety percent of the index group had undergone assisted conception. Mothers >45 years had a fourfold increase in cesarean section (35/64 vs 8/64), a threefold increase in blood loss (669.2 vs 272.4 ml) (both p < 0.001) and were more likely to have preterm birth (12/64 vs 3/64) (p < 0.05). Only 5 % of the 64 women were born in the United Kingdom, 52 % were unemployed and 50 % were not fluent in English. Seventy-five percent of the study population were multiparous, 52 % of the pregnancies were unplanned and 90 % had conceived spontaneously.
  
  
  CONCLUSIONS
  In an inner city immigrant population, older mothers >45 years were more likely to have cesarean sections, postpartum hemorrhage and premature deliveries. Moreover, social and demographic factors suggest that late child bearing is influenced by cultural factors such as acceptance of large families and lack of contraception.
authors.affiliation: University College London Medical School, Gower St, London, WC1E 6BT, UK.
authors.forename: Shaine
authors.initials: S
authors.lastname: Mehta
authors.forename: Kim
authors.initials: K
authors.lastname: Tran
authors.forename: Laura
authors.initials: L
authors.lastname: Stewart
authors.forename: Eleanor
authors.initials: E
authors.lastname: Soutter
authors.forename: Maud
authors.initials: M
authors.lastname: Nauta
authors.forename: Wai
authors.initials: W
authors.lastname: Yoong
mesh_terms: D000328:Adult; D000367:Age Factors; D016022:Case-Control Studies; D002585:Cesarean Section / Q000706:statistics & numerical data; D054242:Emigrants and Immigrants; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D007231:Infant, Newborn; D008131:London / Q000453:epidemiology; D008423:Maternal Age; D008875:Middle Aged; D010298:Parity; D006473:Postpartum Hemorrhage / Q000453:epidemiology / Q000208:ethnology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000208:ethnology; D011256:Pregnancy Outcome / Q000453:epidemiology / Q000208:ethnology*; D018566:Pregnancy, High-Risk; D047928:Premature Birth / Q000453:epidemiology / Q000208:ethnology; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D055815:Young Adult