title: Maternal age and risk of labor and delivery complications.
abstract: We utilized an updated nationally representative database to examine associations between maternal age and prevalence of maternal morbidity during complications of labor and delivery. We used hospital inpatient billing data from the 2009 United States Nationwide Inpatient Sample, part of the Healthcare Cost and Utilization Project. To determine whether the likelihood that maternal morbidity during complications of labor and delivery differed among age groups, separate logistic regression models were run for each complication. Age was the main independent variable of interest. In analyses that controlled for demographics and clinical confounders, we found that complications with the highest odds among women, 11-18 years of age, compared to 25-29 year old women, included preterm delivery, chorioamnionitis, endometritis, and mild preeclampsia. Pregnant women who were 15-19 years old had greater odds for severe preeclampsia, eclampsia, postpartum hemorrhage, poor fetal growth, and fetal distress. Pregnant women who were ≥35 years old had greater odds for preterm delivery, hypertension, superimposed preeclampsia, severe preeclampsia, and decreased risk for chorioamnionitis. Older women (≥40 years old) had increased odds for mild preeclampsia, fetal distress, and poor fetal growth. Our findings underscore the need for pregnant women to be aware of the risks associated with extremes of age so that they can watch for signs and symptoms of such complications.
authors.affiliation: Department of Psychiatry, Washington University School of Medicine, Campus Box 8134, 660 South Euclid, St. Louis, MO, 63110, USA, rehgp@psychiatry.wustl.edu.
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Cavazos-Rehg
authors.forename: Melissa J
authors.initials: MJ
authors.lastname: Krauss
authors.forename: Edward L
authors.initials: EL
authors.lastname: Spitznagel
authors.forename: Kerry
authors.initials: K
authors.lastname: Bommarito
authors.forename: Tessa
authors.initials: T
authors.lastname: Madden
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Olsen
authors.forename: Harini
authors.initials: H
authors.lastname: Subramaniam
authors.forename: Jeffrey F
authors.initials: JF
authors.lastname: Peipert
authors.forename: Laura Jean
authors.initials: LJ
authors.lastname: Bierut
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D005316:Fetal Distress / Q000453:epidemiology / Q000209:etiology; D005317:Fetal Growth Retardation / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D008423:Maternal Age; D007744:Obstetric Labor Complications / Q000453:epidemiology / Q000209:etiology*; D007752:Obstetric Labor, Premature / Q000453:epidemiology / Q000209:etiology; D006473:Postpartum Hemorrhage / Q000453:epidemiology / Q000209:etiology; D011225:Pre-Eclampsia / Q000453:epidemiology / Q000209:etiology; D011247:Pregnancy; D012307:Risk Factors; D055815:Young Adult