title: The impact of advanced maternal age on peripartum thromboelastographic coagulation profiles: a prospective observational exploratory study.
abstract: OBJECTIVE
  Advanced maternal age (AMA) is a known risk factor for pregnancy-related venous thromboembolism. However, it is unclear if underlying differences exist in the maternal coagulation profiles of AMA vs non-AMA women. The aim of this prospective observational study was to compare peripartum thromboelastography parameters of AMA and non-AMA women undergoing elective Cesarean delivery (CD).
  
  
  METHODS
  We compared the peripartum thromboelastographic profiles of healthy AMA women (age > 35 yr) and non-AMA women (age ≤ 35 yr) undergoing elective CD under neuraxial anesthesia. Blood samples were drawn prior to CD and at 24 hr and 72 hr post-CD. At each time point, we assessed thromboelastographic and other standard laboratory coagulation indices. We used a linear mixed-effects regression model (SAS(®) PROC MIXED) to assess between-group differences for individual thromboelastographic and laboratory coagulation parameters.
  
  
  RESULTS
  The median [interquartile range] ages of women were 38 [37-41] yr and 29 [25-34] yr in the AMA and non-AMA groups, respectively (P < 0.001). We observed no statistically significant effect of study group on any thromboelastographic or laboratory coagulation parameters. No statistically significant correlations were found between any thromboelastographic parameter and maternal age. Peripartum thromboelastography and coagulation profiles of healthy AMA and healthy non-AMA women up to 72 hr post-CD were also similar.
  
  
  CONCLUSIONS
  These data suggest that maternal thromboelastographic profiles of healthy AMA and non-AMA women undergoing elective CD are similar. The study was registered at ClinicalTrials.gov (identifier: NCT01416454).
authors.affiliation: Department of Anesthesiology (MC:5640), Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA, USA, ajbut@stanford.edu.
authors.forename: Alexander
authors.initials: A
authors.lastname: Butwick
authors.forename: Maria C
authors.initials: MC
authors.lastname: Gutierrez
authors.forename: Gillian
authors.initials: G
authors.lastname: Hilton
mesh_terms: D000328:Adult; D000367:Age Factors; D001777:Blood Coagulation / Q000502:physiology*; D002585:Cesarean Section; D005260:Female; D006801:Humans; D016014:Linear Models; D008423:Maternal Age; D058725:Peripartum Period; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors; D013916:Thrombelastography