55,512 research outputs found

    Advanced maternal age

    Get PDF
    The average age of women at childbirth in industrialised nations has been increasing steadily for approximately 30 years. Women aged 35 years or over have an increased risk of gestational hypertensive disease, gestational diabetes, placenta praevia, placental abruption, perinatal death, preterm labour, fetal macrosomia and fetal growth restriction. Unsurprisingly, rates of obstetric intervention are higher among older women. Of particular concern is the increased risk of antepartum stillbirth at term in women of advanced maternal age. In all maternal age groups, the risk of stillbirth is higher among nulliparous women than among multiparous women. Women of advanced maternal age (more than 40 years) should be given low dose aspirin (in the presence of an additional risk factor for pre-eclampsia) and offered serial ultrasounds for fetal growth and wellbeing; given the increased risk of antepartum stillbirth, induction of labour from 39 weeks’ gestation should be discussed with the woman

    The health and development of children born to older mothers in the United Kingdom: observational study using longitudinal cohort data

    Get PDF
    Objective: To assess relations between children’s health and development and maternal age. Design: Observational study of longitudinal cohorts. Setting: Millennium Cohort Study (a random sample of UK children) and the National Evaluation of Sure Start study (a random sample of children in deprived areas in England), 2001 to 2007. Participants: 31 257 children at age 9 months, 24 781 children at age 3 years, and 22 504 at age 5 years. Main outcome measures: Childhood unintentional injuries and hospital admissions (aged 9 months, 3 years, and 5 years), immunisations (aged 9 months and 3 years), body mass index, language development, and difficulties with social development (aged 3 and 5 years). Results: Associations were independent of personal and family characteristics and parity. The risk of children having unintentional injuries requiring medical attention or being admitted to hospital both declined with increasing maternal age. For example, at three years the risk of unintentional injuries declined from 36.6% for mothers aged 20 to 28.6% for mothers aged 40 and hospital admissions declined, respectively, from 27.1% to 21.6%. Immunisation rates at nine months increased with maternal age from 94.6% for mothers aged 20 to 98.1% for mothers aged 40. At three years, immunisation rates reached a maximum, at 81.3% for mothers aged 27, being lower for younger and older mothers. This was linked to rates for the combined measles, mumps, and rubella immunisation because excluding these resulted in no significant relation with maternal age. An increase in overweight children at ages 3 and 5 years associated with increasing maternal age was eliminated once maternal body mass index was included as a covariate. Language development was associated with improvements with increasing maternal age, with scores for children of mothers aged 20 being lower than those of children of mothers aged 40 by 0.21 to 0.22 standard deviations at ages 3 and 4 years. There were fewer social and emotional difficulties associated with increasing maternal age. Children of teenage mothers had more difficulties than children of mothers aged 40 (difference 0.28 SD at age 3 and 0.16 SD at age 5). Conclusion: Increasing maternal age was associated with improved health and development for children up to 5 years of age

    Maternal nutritional status mediates the association between maternal age and birth outcomes

    Get PDF
    Young maternal age during pregnancy is linked with adverse birth outcomes. This study examined the role of maternal nutritional status in the association between maternal age and small for gestational age (SGA) delivery and birth length. We used data from a birth cohort study in Ethiopia, involving women who were 15-24 years of age and their newborns. A mediation analysis was fitted in a sample of 1,422 mother infant dyads for whom data on birth length were available, and 777 dyads for whom gestational age and birth weight was measured. We used commands, medeff for the mediation analysis and medsens for sensitivity analysis in STATA 14. Maternal nutritional status, measured by mid-upper arm circumference, mediated 21% of the association between maternal age and birth length and 14% of the association with SGA delivery. The average direct effect (ADE) of maternal age on birth length was (beta = 0.45, 95% CI [0.17, 0.99]) and the average causal mediated effect (ACME) was (beta = 0.12, 95% CI [0.02, 0.15]). We also found an ADE (beta = 0.31, 95% CI [0.09, 0.47]) and an ACME of (beta = 0.05, 95% CI [0.003, 0.205]) of maternal age on SGA delivery. The sensitivity analysis suggests an unmeasured confounder with a positive correlation of 0.15 and 0.20 between the mediator and the outcome could explain the observed ACME for birth length and SGA, respectively. We cannot make strong causal assertions as the findings suggest the mediator partly explained the total effect of maternal age on both outcomes

    Maternal Age, History of Disease, Nutritional Status in Pregnancy, and Their Association with Low Birth-Weight in Aisiyah Hospital, Kudus, Central Java

    Full text link
    BACKGROUND: Low Birth Weight (LBW) is a risk factor for diabetes mellitus and coronary heart disease in adult. The incidence of LBW remained high in Indonesia. Deleterious bio-psychosocial exposure during the gestation period may have negative impact on birth-weight. This study aimed to determine the association between maternal age, history of disease, nutritional status in pregnancy, and low birth weight. SUBJECT AND METHODS: This was a cross-sectional study conducted in Kudus district, Central Java. A sample of 59 new-born babies was selected from Aisiyah Hospital for this study. The dependent variable was birth-weight. The independent variables were maternal age, history of disease, and nutritional status. Maternal age and history of disease were measured by questionnaire. Nutritional status during pregnancy was measured anthropometry. Bivariate analysis involving Odds Ratio and Chi Square test was used to analyze the data. RESULTS: Maternal age <20 years or ≥35 years old increased the risk of delivering LBW infants 1.24 times as many as maternal age between 20 and 35 years old, although it was not statistically significant (OR=1.24; 95%CI=0.28 to 5.42; p=0.775). Pregnant mother with history of disease had the risk of delivering LBW infants 4 times as many as pregnant mother without history of disease, and it was marginally significant (OR=4.00; 95%CI=0.89 to 17.87; p=0.057). Pregnant mother with protein energy malnutrition had the risk of delivering LBW infants 7.5 times as many as pregnant mother without protein energy malnutrition and it was statistically significant (OR=7.53; 95%CI=1.43 to 39.49; p=0.008). CONCLUSION: History of disease and protein energy malnutrition during pregnancy are risk factors for delivering LBW infants. Keywords: low birth-weight, age, history of disease,nutritional statu

    Effect of maternal age on facility-based delivery: analysis of first-order births in 34 countries of sub-Saharan Africa using demographic and health survey data.

    Get PDF
    OBJECTIVES: Increasing access to skilled birth attendance, usually via childbirth in health facilities, is a key intervention to reduce maternal and perinatal mortality and morbidity. Yet, in some countries of sub-Saharan Africa, the uptake is <50%. Age and parity are determinants of facility-based delivery, but are strongly correlated in high fertility settings. This analysis assessed the independent effect of age on facility-based delivery by restricting to first-order births. It was hypothesised that older first-time mothers in this setting might have lower uptake of facility-based deliveries than women in the most common age groups for first birth. SETTING: The most recent Demographic and Health Surveys from 34 sub-Saharan African countries were used to assess women's delivery locations. PARTICIPANTS: 72 772 women having their first birth in the 5 years preceding the surveys were included in the analysis. PRIMARY AND SECONDARY OUTCOME MEASURES: Proportions and 95% CIs of facility-based deliveries were estimated overall and by country. Multivariable logistic regression was used to calculate the odds of facility-based delivery for different maternal age groups (15-19, 20-24 and ≥25 years) for a pooled sample of all countries. RESULTS: 59.9% of women had a facility-based delivery for their first birth (95% CI 58.6 to 61.2), ranging from 19.4% in Chad to 96.6% in Rwanda. Compared with women aged 15-19 years, the adjusted odds of having a facility-based delivery for those aged 20-24 was 1.4 (95% CI 1.3 to 1.5, p<0.001) and for those aged ≥25, 1.9 (95% CI 1.6 to 2.2, p<0.001). CONCLUSIONS: Older age at first birth was independently associated with significantly higher odds of facility-based delivery. This went against the hypothesis. Further mixed-method research is needed to explore how increased age improves uptake of facility-based delivery. Promoting facility-based delivery, while ensuring quality of care, should be prioritised to improve birth outcomes in sub-Saharan Africa

    The Association Between Advanced Maternal Age and Short Interpregnancy Intervals on Preterm Labor

    Get PDF
    Background: Preterm birth is the leading cause of neonatal and infant mortality and has become a major health concern due to the increasing rates of infant deaths in the United States (WHO, 2017). Studying maternal risk factors for preterm labor provides insight to this obscure condition and can assist in the identification of high risk women, as well as facilitate appropriate pregnancy planning. Purpose: Although research can be found on interpregnancy intervals and maternal age as independent risk factors for premature labor, gaps exist within the relation of these variables. This study was done to investigate whether there is a significant risk association between advanced maternal age (35 years and older) and short interpregnancy intervals on premature labor, that deems transferring out of a low risk birthing center to a more advanced hospitalized setting. Methodology: De-identified data regarding obstetric history, medical history, and pregnancy morbidity was abstracted from women who delivered at Baby + Co., a birthing center in Nashville, Tennessee, between the years of 2015 and 2018. The population set included 1001 women, 5 of which delivered preterm. Means and standard deviations for the two groups were calculated, and two sided t-tests and corresponding p-values were calculated. Result: There was no statistical significance regarding maternal age and preterm transfers (p-value of 0.762). However, there was a positive correlation between short interpregnancy intervals and preterm birth (p-value .007). Discussion: Due to the low risk population included in this study, there is a need for additional research conducted within a higher risk population set to determine the significance and interaction between advanced maternal age and short interpregnancy intervals on preterm labor

    Child abuse registration, fetal growth, and preterm birth: a population based study

    Get PDF
    Objectives: To study the relation of intra-uterine growth and gestational age with child protection registration in a 20 year whole population birth cohort. Setting: West Sussex area of England. Study design: Retrospective whole population birth cohort. Outcomes: Child protection registration; individual categories of registration—sexual abuse, physical abuse, emotional abuse, and neglect. Population and participants: 119 771 infants born in West Sussex between January 1983 and December 2001 with complete data including birth weight, gestational age, maternal age, and postcode. Results: In all categories of registration a linear trend was noted such that the lower the birth weight z score the higher the likelihood of child protection registration. Similar trends were noted for gestational age. All these trends were robust to adjustment for maternal age and socioeconomic status. Conclusions: The results of this study suggest that lower levels of fetal growth and shorter gestational duration are associated with increased likelihood of child protection registration in all categories including sexual abuse independent of maternal age or socioeconomic status. This study does not permit comment on whether poor fetal growth or preterm birth predispose to child abuse and neglect or the association arises because they share a common pathway

    Description of Maternal Age, Parity, and Birth Spacing, in Infants with Low Birthweight in Karawang, West Java

    Full text link
    Background: Low birth weight (LBW) is a major public health problem in low income countries. LBW is associated with a range of both short and long term consequences. Maternal and fetal factors may determine the risk of LBW. This study aimed to describe the maternal age, parity, and birth spacing, ininfants with LBW, in Karawang, West Java. Subjects and Method: This was a descriptive cross-sectional study conducted at Citra Sari Husada hospital, Karawang, West Java. A sample of 70 infants with low birth weight was selected by simple random sampling. The study variables were age, parity, birth spacing, and history of delivery of previous LBW babies. The data were taken from medical records. The data of each variable were described in percent. Results: The cumulative incidence of LBW infantsin 2014 was 386 cases (20.29%) of the 1902 mothers who gave birth at Citra Sari Husada hospital, Karawang, West Java. Mothers who gave birth to LBW were mostly 20-35 years old (61.42%), 74.28% 2-3 parity, 81.42% ≥2 years birth spacing, and 92% had history of LBW baby in previous pregnancy. Conclusion: The incidence of LBW has been described by maternal age, parity, birth spacing, and history of LBW in previous pregnancy. Keywords: maternal age, parity, birth spacing, low birthweigh

    Maternal age related issues

    Get PDF
    This issue of eMedRef provides information to clinicians on possible complications and recommendations for maternal age related issues in pregnancy

    Prediction of preterm birth with and without preeclampsia using mid-pregnancy immune and growth-related molecular factors and maternal characteristics.

    Get PDF
    OBJECTIVE:To evaluate if mid-pregnancy immune and growth-related molecular factors predict preterm birth (PTB) with and without (±) preeclampsia. STUDY DESIGN:Included were 400 women with singleton deliveries in California in 2009-2010 (200 PTB and 200 term) divided into training and testing samples at a 2:1 ratio. Sixty-three markers were tested in 15-20 serum samples using multiplex technology. Linear discriminate analysis was used to create a discriminate function. Model performance was assessed using area under the receiver operating characteristic curve (AUC). RESULTS:Twenty-five serum biomarkers along with maternal age &lt;34 years and poverty status identified &gt;80% of women with PTB ± preeclampsia with best performance in women with preterm preeclampsia (AUC = 0.889, 95% confidence interval (0.822-0.959) training; 0.883 (0.804-0.963) testing). CONCLUSION:Together with maternal age and poverty status, mid-pregnancy immune and growth factors reliably identified most women who went on to have a PTB ± preeclampsia
    corecore