Journal ArticleDOI
Maternal age and adverse pregnancy outcome: a cohort study
Asma Khalil,Argyro Syngelaki,Argyro Syngelaki,Nerea Maiz,Yana Zinevich,Yana Zinevich,Kypros H. Nicolaides,Kypros H. Nicolaides +7 more
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TLDR
To examine the association between maternal age and a wide range of adverse pregnancy outcomes after adjustment for confounding factors in obstetric history and maternal characteristics, a large number of women under the age of 40 have experienced at least one adverse pregnancy outcome.Abstract:
Objective To examine the association between maternal age and a wide range of adverse pregnancy outcomes after adjustment for confounding factors in obstetric history and maternal characteristics. Methods This was a retrospective study in women with singleton pregnancies attending the first routine hospital visit at 11+ 0t o 13+ 6 weeks’ gestation. Data on maternal characteristics, and medical and obstetric history were collected and pregnancy outcomes ascertained. Maternal age was studied, both as a continuous and as a categorical variable. Regression analysis was performed to examine the association between maternal age and adverse pregnancy outcome including preeclampsia, gestational hypertension, gestational diabetes mellitus (GDM), preterm delivery, small-for-gestational age (SGA) neonate, large-for-gestational age (LGA) neonate, miscarriage, stillbirth and elective and emergency Cesarean section. Results The study population included 76 158 singleton pregnancies with a live fetus at 11 + 0t o 13+ 6 weeks. After adjusting for potential maternal and pregnancy confounding variables, advanced maternal age (defined as ≥ 40 years) was associated with increased risk of miscarriage (odds ratio (OR), 2.32 (95% CI, 1.83–2.93); P < 0.001), pre-eclampsia (OR, 1.49 (95% CI, 1.22–1.82); P < 0.001), GDM (OR, 1.88 (95% CI, 1.55–2.29); P < 0.001), SGA (OR, 1.46 (95% CI, 1.27–1.69); P < 0.001) and Cesarean section (OR, 1.95 (95% CI, 1.77–2.14); P < 0.001), but not with stillbirth, gestational hypertension, spontaneous preterm delivery or LGA. Conclusions Maternal age should be combined with other maternal characteristics and obstetric history when calculating an individualized adjusted risk for adverse pregnancy complications. Advanced maternal age is aread more
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Journal ArticleDOI
Clinical risk factors for pre-eclampsia determined in early pregnancy: systematic review and meta-analysis of large cohort studies
TL;DR: A practical evidence based list of clinical risk factors that can be assessed by a clinician at ≤16 weeks’ gestation to estimate a woman’s risk of pre-eclampsia and the use of aspirin prophylaxis in pregnancy is developed.
Journal ArticleDOI
The International Federation of Gynecology and Obstetrics (FIGO) initiative on pre-eclampsia: A pragmatic guide for first-trimester screening and prevention.
Liona C. Poon,Andrew Shennan,Jonathan A. Hyett,Anil Kapur,Eran Hadar,Hema Divakar,Fionnuala M. McAuliffe,Fabricio da Silva Costa,Peter von Dadelszen,Harold David McIntyre,A.B. Kihara,Gian Carlo Di Renzo,Roberto Romero,Mary E. D'Alton,Vincenzo Berghella,Kypros H. Nicolaides,Moshe Hod +16 more
TL;DR: The quest to effectively predict PE in the first trimester of pregnancy is fueled by the desire to identify women who are at high risk of developing PE, so that necessary measures can be initiated early enough to improve placentation and thus prevent or at least reduce the frequency of its occurrence.
Journal ArticleDOI
Advanced maternal age and adverse pregnancy outcomes: A systematic review and meta-analysis.
Samantha C. Lean,Samantha C. Lean,Hayley Derricott,Rebecca Jones,Rebecca Jones,Alexander E. P. Heazell,Alexander E. P. Heazell +6 more
TL;DR: It is proposed that placental dysfunction may mediate adverse pregnancy outcome in AMA and stillbirth risk increases with increasing maternal age, not wholly explained by maternal co-morbidities and use of ART.
Journal ArticleDOI
Indications for and Risks of Elective Cesarean Section.
Ioannis Mylonas,Klaus Friese +1 more
TL;DR: Scientific advances, social and cultural changes, and medicolegal considerations seem to be the main reasons for the increased acceptibility of cesarean sections.
Journal ArticleDOI
Effect of maternal age on the risk of preterm birth: A large cohort study.
TL;DR: Even after adjustment for confounders, advanced maternal age (40 years and over) was associated with preterm birth, and a maternal age of 30–34 years wasassociated with the lowest risk of prematurity.
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