title: Adverse perinatal outcomes for advanced maternal age: a cross-sectional study of Brazilian births.
abstract: OBJECTIVE
  To investigate the risk of adverse perinatal outcomes in women aged ≥41 years relatively to those aged 21-34.
  
  
  METHODS
  Approximately 8.5 million records of singleton births in Brazilian hospitals in the period 2004-2009 were investigated. Odds ratios were estimated for preterm and post-term births, for low Apgar scores at 1 min and at 5 min, for asphyxia, for low birth weight, and for macrosomia.
  
  
  RESULTS
  For pregnant women ≥41, increased risks were identified for preterm births, for post-term births (except for primiparous women with schooling ≥12 years), and for low birth weight. When comparing older vs. younger women, higher educational levels ensure similar risks of low Apgar score at 1 min (for primiparous mothers and term births), of low Apgar score at 5 min (for term births), of macrosomia (for non-primiparous women), and of asphyxia.
  
  
  CONCLUSIONS
  As a rule, older mothers are at higher risk of adverse perinatal outcomes, which, however, may be mitigated or eliminated, depending on gestational age, parity, and, especially, on the education level of the pregnant woman.
authors.affiliation: Department of Statistics, Universidade Federal Fluminense (UFF), Niterói, RJ, Brazil.
authors.forename: Núbia Karla O
authors.initials: NK
authors.lastname: Almeida
authors.affiliation: Biomedical Engineering Program, Instituto Alberto Luiz Coimbra de Pós-Graduação e Pesquisa de Engenharia (COPPE), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil. Electronic address: renan@peb.ufrj.br.
authors.forename: Renan M V R
authors.initials: RM
authors.lastname: Almeida
authors.affiliation: Electrical Engineering Program, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil; Medicine Scholl, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil; Programa de Engenharia de Sistemas e Computação (PESC), Instituto Alberto Luiz Coimbra de Pós-Graduação e Pesquisa de Engenharia (COPPE), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.
authors.forename: Carlos Eduardo
authors.initials: CE
authors.lastname: Pedreira
mesh_terms: D000328:Adult; D001034:Apgar Score; D001238:Asphyxia Neonatorum / Q000453:epidemiology; D001938:Brazil / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D005320:Fetal Macrosomia / Q000453:epidemiology; D005865:Gestational Age; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008423:Maternal Age; D010298:Parity; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011295:Prenatal Care / Q000706:statistics & numerical data; D018570:Risk Assessment; D055815:Young Adult
keywords: Adverse perinatal outcome; Educational level; Fator de risco; Idade materna; Maternal age; Nível de escolaridade; Resultado perinatal adverso; Risk factors