To Evaluate the Effect of Increasing Maternal Age on Maternal and Neonatal Outcomes in Pregnancies at Advanced Maternal Age.

Abstract

Introduction: Late pregnancies have been a sensitive issue in the society and medical field for many years. The reason for this development could be the increasing use of reproductive techniques, women empowerment and late conceptions. The increased level of education in women, having more responsibilities at work, giving priority to their professional career could be leading to delay in conception and childbearing. Many studies have investigated the effect of advanced maternal age on fetal outcome suggesting higher risk of poor neonatal outcome. Recent studies have debated these outcomes.[1234].

Aims and objectives: To evaluate the effect of increasing maternal age on maternal and neonatal outcomes in pregnancies at advanced maternal age.

Material and methods: The study was conducted on 843 women above the age of 35 years who delivered at Dayanand Medical College and Hospital during 2015-2020. Patients were categorized into 2 groups, Group A comprised of pregnant women aged 35-40 years; group B included pregnant women aged >40 years. Various other parameters including parity, gestation at delivery, whether the pregnancies were spontaneous or conceived through ART (assisted reproductive techniques) and other associated co-morbid conditions were noted. The obstetrical, gynecological, medical, surgical, fetal and neonatal complications were studied in both the groups and the data was analyzed with release 9.4 (SAS Institute Inc, Cary, NC).

Results: Out of 843 patients in our study, 81.4% (n=687) belonged to the age group of 35- 40 years. 18.5% (n=156) belonged to the age group of > 40 years. Patients more than 40 years underwent ART for conception more often as compared to group A. Co-morbid medical conditions including chronic hypertension, thyroid diseases, auto immune disorders and obstetric complications such as abortions, oligohydramnios, GDM, placenta previa, PPH was significantly more common in patients with group B. Cesarean delivery rate was significantly more in group B as compared to group A. Neonatal outcome in terms of NICU admissions and preterm birth at less than 35 weeks gestation was seen more frequently in group B as compared to Group A.

Conclusion: Our study concludes that the decision to delay childbearing should be discouraged owing to increased maternal and fetal morbidity associated with advanced maternal age, the risks being higher with increasing maternal age.