Titre
Peripartum outcomes associated with advanced maternal age over 40 years : a retrospective cohort study
Type
mémoire de master/maîtrise/licence
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Auteur(s)
BRAGGION, A.
Auteure/Auteur
Directrices/directeurs
DESSEAUVE, D.
Directeur⸱rice
FAVRE, G.
Codirecteur⸱rice
Liens vers les personnes
Liens vers les unités
Faculté
Université de Lausanne, Faculté de biologie et médecine
Statut éditorial
Accepté
Date de publication
2022
Nombre de pages
23
Langue
anglais
Résumé
Background: The number of women delivering at an advanced maternal age is increasing worldwide. The aim of this study was to assess the risk of adverse peripartum outcomes in advanced maternal age (AMA) patients of 40 years or older compared to women younger than 40 years.
Methods: This was a retrospective cohort study performed on data of deliveries from January 2015 to December 2019 in a tertiary university hospital in Lausanne, Switzerland (CHUV). We included all women of 18 years or older who delivered after 24 weeks of gestation. Subjects were divided into 2 age groups: 1) ≥ 40 years and 2) < 40 years. Multivariate logistic regression analysis was used on the primary outcome. It was defined as a composite of adverse peripartum outcomes of at least one of the following: preterm birth, emergency cesarean section (C-section), assisted vaginal delivery, high degree perineal tears, postpartum hemorrhage, artificial placenta delivery, severe neonatal acidosis and neonatal intensive care unit (NICU) admission. Secondary outcomes were classified into pregnancy outcomes, postpartum outcomes and neonatal outcomes.
Results: A total of 13.510 patients were included: 870 (6.44%) women ≥ 40 years (AMA) in the first group and 12 640 (93.56%) < 40 years in the second. Advanced maternal age was significantly associated with peripartum adverse outcomes (aOR=1.57, 95% CI 1.35-1.81; p<0.001), preterm birth before 37 weeks (aOR=1.28, 95% CI 1.04-1.58; p=0.022), postpartum hemorrhage (aOR=1.41, 95% CI 1.10-1.80; p=0.006), neonatal acidosis < 7.0 (aOR=3.14, 95% CI 1.79-5.49; p<0.001), NICU admission (aOR=1.51, 95% CI 1.14-1.99; p=0.004), emergency C-section (aOR=1.84, 95% CI 1.51-2.25; p<0.001), assisted vaginal delivery (aOR=1.55, 95% CI 1.14-2.11; p=0.005) and artificial placenta delivery (aOR=2.03, 95% CI 1.42-2.91; p<0.001) (table 2). High degree perineal tears were not significant (aOR=0.59, 95% CI 0.08-4.36; p=0.609).
Conclusion: Advanced maternal age is an independent risk factor for a wide range of adverse peripartum outcomes. As women are getting pregnant at an increasing age, it is crucial to take into account maternal age, together with medical history, when assessing the individual risk of obstetrical and neonatal complications.
Methods: This was a retrospective cohort study performed on data of deliveries from January 2015 to December 2019 in a tertiary university hospital in Lausanne, Switzerland (CHUV). We included all women of 18 years or older who delivered after 24 weeks of gestation. Subjects were divided into 2 age groups: 1) ≥ 40 years and 2) < 40 years. Multivariate logistic regression analysis was used on the primary outcome. It was defined as a composite of adverse peripartum outcomes of at least one of the following: preterm birth, emergency cesarean section (C-section), assisted vaginal delivery, high degree perineal tears, postpartum hemorrhage, artificial placenta delivery, severe neonatal acidosis and neonatal intensive care unit (NICU) admission. Secondary outcomes were classified into pregnancy outcomes, postpartum outcomes and neonatal outcomes.
Results: A total of 13.510 patients were included: 870 (6.44%) women ≥ 40 years (AMA) in the first group and 12 640 (93.56%) < 40 years in the second. Advanced maternal age was significantly associated with peripartum adverse outcomes (aOR=1.57, 95% CI 1.35-1.81; p<0.001), preterm birth before 37 weeks (aOR=1.28, 95% CI 1.04-1.58; p=0.022), postpartum hemorrhage (aOR=1.41, 95% CI 1.10-1.80; p=0.006), neonatal acidosis < 7.0 (aOR=3.14, 95% CI 1.79-5.49; p<0.001), NICU admission (aOR=1.51, 95% CI 1.14-1.99; p=0.004), emergency C-section (aOR=1.84, 95% CI 1.51-2.25; p<0.001), assisted vaginal delivery (aOR=1.55, 95% CI 1.14-2.11; p=0.005) and artificial placenta delivery (aOR=2.03, 95% CI 1.42-2.91; p<0.001) (table 2). High degree perineal tears were not significant (aOR=0.59, 95% CI 0.08-4.36; p=0.609).
Conclusion: Advanced maternal age is an independent risk factor for a wide range of adverse peripartum outcomes. As women are getting pregnant at an increasing age, it is crucial to take into account maternal age, together with medical history, when assessing the individual risk of obstetrical and neonatal complications.
Sujets
PID Serval
serval:BIB_60E538754313
Date de création
2023-09-13T08:11:25.204Z
Date de création dans IRIS
2025-05-20T16:37:46Z
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