title: Postponed pregnancies and risks of very advanced maternal age.
abstract: OBJECTIVE
  To evaluate pregnancy outcome in pregnant women aged ≥45 years, termed very advanced maternal age (VAMA).
  
  
  METHODS
  We retrospectively compared the outcome of pregnancies in VAMA patients with controls aged 30 years at time of delivery. Subgroups of singleton and multiple pregnancies were also analysed. Incidences of maternal and fetal adverse outcomes were measured. Statistical significance was set at p <0.05. Odds ratios (ORs) were adjusted where necessary.
  
  
  RESULTS
  One hundred and twenty-seven VAMA pregnancies and 2066 control pregnancies of women aged 30 years were analysed. VAMA pregnancies had a higher rate of maternal complications such as gestational hypertension (3.9% vs 0.6%; OR 6.5), preeclampsia (14.2% vs 3.0%; OR 5.4, adjusted OR 4.4) and gestational diabetes (12.6% vs 3.6%; OR 3.8). Likewise, increased need for blood transfusion (3.2% vs 0.7%; OR 4.8, adjusted OR 4.4) and prolonged hospitalisation >7 days (37.8% vs 15.1%; OR 3.42) was found. Infant complications such as prematurity (44.9% vs 16.2%; OR 4.2) and low birthweight <5th percentile (11.0% vs 5.6%; OR 2.1) were also increased.
  
  
  CONCLUSIONS
  Pregnant women of very advanced maternal age (≥45 years) have significantly increased maternal and fetal risks. Women postponing pregnancy or planning a pregnancy in very advanced age should be informed about these risks, in particular before artificial reproductive technologies are applied or "social freezing".
authors: Division of Obstetrics, University Hospital of Zürich, Switzerland.
authors: Christian
authors: C
authors: Haslinger
authors: Division of Obstetrics, University Hospital of Zürich, Switzerland.
authors: Bernhard
authors: B
authors: Stoiber
authors: Division of Obstetrics, University Hospital of Zürich, Switzerland.
authors: Federica
authors: F
authors: Capanna
authors: Division of Obstetrics, University Hospital of Zürich, Switzerland.
authors: Marie-Kristin
authors: MK
authors: Schäffer
authors: Division of Obstetrics, University Hospital of Zürich, Switzerland.
authors: Roland
authors: R
authors: Zimmermann
authors: Division of Obstetrics, Kantonsspital Baden, Switzerland.
authors: Leonhard
authors: L
authors: Schäffer
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002585:Cesarean Section; D016208:Databases, Factual; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D016015:Logistic Models; D008423:Maternal Age; D008875:Middle Aged; D011225:Pre-Eclampsia / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011272:Pregnancy, Multiple / Q000706:statistics & numerical data; D047928:Premature Birth / Q000453:epidemiology; D012189:Retrospective Studies; D012306:Risk; D013557:Switzerland / Q000453:epidemiology