title: Obstetric and neonatal outcomes for women ≥ 45 years of age: a cohort study.
abstract: OBJECTIVE
  To evaluate outcomes in women ≥ 45 years of age in comparison to a group of women aged 40 to 44 years.
  
  
  METHODS
  A cohort study was conducted including women ≥ 45 years who delivered at > 24 weeks gestation during the period (1989-2011). Women aged 40 to 44 years formed the comparison group. The maternal demographics, mode of conception, maternal complications, timing and mode of delivery, neonatal features and postpartum complications were included as outcomes. Statistical analyses were performed using the t-test and Chi-square test.
  
  
  RESULTS
  There were 67,278 deliveries; 140 occurred in women ≥ 45 years of age, (2.1/1,000). Compared with the 40 to 44 year age group (n = 139), women ≥ 45 years had higher body mass index (26.7 ± 4.7 vs. 24.6 ± 7.1, p = 0.01), and were more likely to have a previous pregnancy loss at < 24 weeks gestation (57.9 vs. 44.6%, p = 0.03). There was no difference in the incidence of maternal complications, preterm delivery, birthweight, Apgar scores or admission to neonatal intensive care. The presence of pre-existing maternal hypertension was associated with a poor outcome. Women ≥ 45 years were more likely to be delivered by cesarean section (45 vs. 30.2%, p = 0.01).
  
  
  CONCLUSIONS
  Women aged ≥ 45 years have comparable outcomes to those aged 40 to 44 years, albeit the presence of pre-existing maternal disease is higher and associated with a poor outcome.
authors: Department of Obstetrics and Gynecology, National University of Ireland Galway, Galway University Hospital, Ireland.
authors: Niamh A
authors: NA
authors: McDonnell
authors: Department of Obstetrics and Gynecology, National University of Ireland Galway, Galway University Hospital, Ireland.
authors: Jennifer M
authors: JM
authors: Walsh
authors: Department of Obstetrics and Gynecology, National University of Ireland Galway, Galway University Hospital, Ireland.
authors: Siobhan C
authors: SC
authors: Carruthers
authors: Department of Obstetrics and Gynecology, National University of Ireland Galway, Galway University Hospital, Ireland.
authors: John J
authors: JJ
authors: Morrison
mesh_terms: D000328:Adult; D001034:Apgar Score; D001724:Birth Weight; D015992:Body Mass Index; D002585:Cesarean Section / Q000706:statistics & numerical data*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007231:Infant, Newborn; D008423:Maternal Age; D008875:Middle Aged; D054238:Perinatal Mortality; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome / Q000453:epidemiology*