Background: Advanced maternal age, over 35 years, is a well-known risk factor for
poor pregnancy outcomes. It is commonly associated with various pregnancy
complications, such as spontaneous miscarriage, preeclampsia/toxemia,
gestational diabetes mellitus, preterm labor, stillbirth, chromosomal
abnormalities, and cesarean delivery. Objectives: This study assessed
obstetric and neonatal complications associated with advanced maternal age. Methods: We reviewed the medical records of 199 pregnant women over 35 years old at King
Abdulaziz University Hospital in Jeddah, Saudi Arabia, from January to June
2022. We gathered data on age, nationality, number of antenatal visits, results
of ultrasound scans for dating and viability, nuchal translucency and anatomy
surveys, medications and multivitamins taken during pregnancy, smoking status,
pregnancy, and fetal complications, and mode of delivery. Results: The
prevalence of obstetric complications was 71.4% (preeclampsia/toxemia, 4.5%;
antepartum hemorrhage, 4%; postpartum hemorrhage, 1%; and gestational diabetes,
23.1%). The most frequent complication was preterm labor between 34 and 36
weeks (48%), and only 12.6% of all deliveries were associated with fetal and
neonatal complications such as congenital anomalies and neonatal jaundice. The
prevalence of anemia during pregnancy was 10.1%, 21.1%, and 28.6% in the first,
second, and third trimesters, respectively, and pregnancies complicated with
antepartum or postpartum hemorrhage were associated with higher rates of anemia
in the second trimester. A significant relationship was found between mean
maternal age (38.84 ± 2.75 years) and the development of maternal complications
(p < 0.05). Newborns with neonatal complications were much more likely to be
born to mothers with a history of antepartum hemorrhage and anemia in the
second trimester. Conclusion: Our findings confirm that pregnancy at an
advanced maternal age is associated with increased overall maternal
complications. The most
References
[1]
Heazell, A.E., Newman, L., Lean, S.C. and Jones, R.L. (2018) Pregnancy Outcome in Mothers over the Age of 35. Current Opinion in Obstetrics and Gynecology, 30, 337-343. https://doi.org/10.1097/GCO.0000000000000494
[2]
AlJahdali, E.A. and AlSinani, N.S. (2022) Pregnancy Outcomes at Advanced Maternal Age in a Tertiary Hospital, Jeddah, Saudi Arabia. Saudi Medical Journal, 43, 491-499. https://doi.org/10.15537/smj.2022.43.5.20220023
[3]
Bayrampour, H., Heaman, M., Duncan, K.A. and Tough, S. (2012, September 19) Advanced Maternal Age and Risk Perception: A Qualitative Study. BMC Pregnancy and Childbirth, 12, Article No. 100. https://doi.org/10.1186/1471-2393-12-100
https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/1471-2393-12-100
[4]
Harrison, B.J., Hilton, T.N., Rivière, R.N., Ferraro, Z.M., Deonandan, R. and Walker, M.C. (2017) Advanced Maternal Age: Ethical and Medical Considerations for Assisted Reproductive Technology. International Journal of Women’s Health, 9, 561-570. https://doi.org/10.2147/IJWH.S139578
[5]
Pawde, A.A., Kulkarni, M.P. and Unni, J. (2015). Pregnancy in Women Aged 35 Years and Above: A Prospective Observational Study. Journal of Obstetrics and Gynaecology of India, 65, 93-96. https://doi.org/10.1007/s13224-014-0616-2
[6]
Nunes, J.S., Ladeiras, R., Machado, L., Coelho, D., Duarte, C. and Furtado, J.M. (2020) A influência da pré-eclampsia, idade materna avançada e obesidade materna em desfechos neonatais entre mulheres com diabetes gestacional. Revista brasileira de ginecologia e obstetricia: revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia, 42, 607-613. https://doi.org/10.1055/s-0040-1710300
[7]
El-Gilany, A.H. and Hammad, S. (2012) Obstetric Outcomes of Teenagers and Older Mothers: Experience from Saudi Arabia. International Journal of Collaborative Research on Internal Medicine & Public Health, 4, 901-909.
[8]
Asefa, U. and Ayele, W.M. (2020) Adverse Obstetrical and Perinatal Outcomes among Advanced Age Pregnant Mothers in Northeast Ethiopia: A Comparative Cross-Sectional Study. International Journal of Women’s Health, 12, 1161-1169.
https://doi.org/10.2147/IJWH.S284124
[9]
Ananth, C.V. and Basso, O. (2010) Impact of Pregnancy-Induced Hypertension on Stillbirth and Neonatal Mortality. Epidemiology, 21, 118-123.
https://doi.org/10.1097/EDE.0b013e3181c297af
[10]
Abu-Zaid, A., Alomari, M., Al-Hayani, M., Bazi, A., Almazmomy, A., Alsaegh, A., Alshawkani, H. and Radwan, A. (2020) Advanced Maternal Age and the Frequency of Pre-Eclampsia—A Single-Center Cross Sectional Study from Saudi Arabia. Journal of Evolution of Medical and Dental Sciences, 9, 2726-2729.
https://doi.org/10.14260/jemds/2020/592
[11]
Shams, T., Gazzaz, T., Althobiti, K., Alghamdi, N., Bamarouf, W., Almarhoumi, L. and Alhashemi, H. (2021) Comparison of Pregnancy Outcomes Between Women of Advanced Maternal Age (≥35 years) Versus Younger Women in a Tertiary Care Center in Saudi Arabia. Annals of Saudi Medicine, 41, 274-279.
https://doi.org/10.5144/0256-4947.2021.274
[12]
Fayed, A.A., Wahabi, H., Mamdouh, H., Kotb, R. and Esmaeil, S. (2017) Demographic Profile and Pregnancy Outcomes of Adolescents and Older Mothers in Saudi Arabia: Analysis from Riyadh Mother (RAHMA) and Baby Cohort Study. BMJ Open, 7, e016501. https://doi.org/10.1136/bmjopen-2017-016501
[13]
Kortekaas, J.C., Kazemier, B.M., Keulen, J.K.J., Bruinsma, A., Mol, B.W., Vandenbussche, F., Van Dillen, J. and De Miranda, E. (2020) Risk of Adverse Pregnancy Outcomes of Late- and Postterm Pregnancies in Advanced Maternal Age: A National Cohort Study. Acta Obstetricia et Gynecologica Scandinavica, 99, 1022-1030.
https://doi.org/10.1111/aogs.13828