title: The impact of parity on perinatal outcomes in pregnancies complicated by advanced maternal age.
abstract: OBJECTIVE
  The purpose of this study was to investigate the impact of parity on perinatal outcomes in pregnancies complicated by advanced maternal age.
  
  
  METHODS
  A total of 11 587 pregnancies were reviewed retrospectively from patient medical records. Singleton pregnancies greater than 24 weeks of gestation were included. The study group consisted of women ≥40 years old at the time of delivery, and the control group consisted of women aged between 20 and 30 years old. Data regarding age, parity, gestational age, mode of delivery, and obstetric and neonatal complications were collected. Firstly, pregnancies ≥40 years and the younger control group were compared altogether with respect to the obstetric and neonatal complications. Secondly, both groups were divided into subgroups according to parity, and a second comparison was made with controls.
  
  
  RESULTS
  Mean maternal age in the study and control groups was 43±2.2 and 24±2.8 years, respectively. In women ≥40 years old, all of the investigated obstetric and neonatal complications except postpartum haemorrhage and foetal malformations were higher when compared to younger controls (p<0.05). In the nulliparous ≥40 year old group, the most significant complications were preterm delivery (45.3%), low 5-minute Apgar score (15.2%), and neonatal intensive care unit admission (15.2%). On the other hand, in the multiparous group, preeclampsia (16.6%), abruptio placentae (5.1%), foetal demise (7.2%), and macrosomia (9.6%) were found to be significantly higher when compared to controls.
  
  
  CONCLUSIONS
  The study suggests that pregnancies of maternal age ≥40 years carry increased risks for both neonatal and obstetric complications, and these risks seem to be effected by parity.
authors.affiliation: Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: Eralp
authors.initials: E
authors.lastname: Başer
authors.affiliation: Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: Kerem Doğa
authors.initials: KD
authors.lastname: Seçkin
authors.affiliation: Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: Selçuk
authors.initials: S
authors.lastname: Erkılınç
authors.affiliation: Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: Mehmet Fatih
authors.initials: MF
authors.lastname: Karslı
authors.affiliation: Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: Ilkin Mahmut
authors.initials: IM
authors.lastname: Yeral
authors.affiliation: Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: Oktay
authors.initials: O
authors.lastname: Kaymak
authors.affiliation: Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: Turhan
authors.initials: T
authors.lastname: Cağlar
authors.affiliation: Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: Nuri
authors.initials: N
authors.lastname: Danışman
keywords: Advanced maternal age; neonatal outcome; parity; perinatal outcome