title: The effects of maternal age and parity on maternal and neonatal outcome.
abstract: OBJECTIVE
  Delayed childbearing is increasingly common; hence, concerns emerge regarding potential for additional risks of delivery at advanced maternal age (AMA; ≥35 years). In this study, we sought to assess impact of AMA and parity on maternal and perinatal outcomes.
  
  
  METHODS
  In this retrospective single-center study (July 2005 to October 2011), we compared spontaneously-conceived singleton births of AMA mothers with spontaneously-conceived singletons of mothers aged 24-27 years. Maternal outcomes: incidence of diabetes, hypertension, and emergency cesarean sections (ECS). Neonatal outcomes: prematurity, birth weight, incidence of small or large for gestational age infants (SGA/LGA, respectively), low birth weight (LBW), and 5'-Apgar scores. Sub-groupings of maternal age were 35-38, 39-42, or 43-47 years; prematurity as <34 or <37 weeks; AMA parity as primiparous, 2-5 births, 6-9 births, or ≥10 births. Binary logistic regression was used for multivariate analyses.
  
  
  RESULTS
  Of 24,579 eligible women, 11,243 were AMA (14.0% total singleton births) and 13,336 were aged 24-27 years (16.7% total singleton births) at delivery. There were no maternal or perinatal deaths. Incidence of maternal hypertension and diabetes was significantly greater in AMA, especially oldest AMA. AMA including primiparous had significantly more ECS than younger including primiparous controls, respectively, and were more likely to deliver LGA neonates. Primiparous AMA women did not have increased incidence of LGA babies but significantly increased incidence of SGA infants.
  
  
  CONCLUSIONS
  AMA, especially primiparous, has more adverse maternal and neonatal outcomes than younger women; however, these did not include mortality. Consistent antenatal care may explain this.
authors.affiliation: Department of Neonatology, Shaare Zedek Medical Center, Affiliated with the Hebrew University, Hadassah Medical School, Jerusalem, Israel.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Schimmel
authors.forename: Ruben
authors.initials: R
authors.lastname: Bromiker
authors.forename: Cathy
authors.initials: C
authors.lastname: Hammerman
authors.forename: Lila
authors.initials: L
authors.lastname: Chertman
authors.forename: Alexander
authors.initials: A
authors.lastname: Ioscovich
authors.forename: Sorina
authors.initials: S
authors.lastname: Granovsky-Grisaru
authors.forename: Arnon
authors.initials: A
authors.lastname: Samueloff
authors.forename: Deborah
authors.initials: D
authors.lastname: Elstein
mesh_terms: D000328:Adult; D001724:Birth Weight; D002585:Cesarean Section / Q000706:statistics & numerical data; D036861:Delivery, Obstetric; D005260:Female; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D008423:Maternal Age; D008875:Middle Aged; D007744:Obstetric Labor Complications / Q000453:epidemiology; D010298:Parity; D036801:Parturition; D011225:Pre-Eclampsia / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome / Q000453:epidemiology*; D047928:Premature Birth / Q000453:epidemiology; D011295:Prenatal Care; D012189:Retrospective Studies