• 作者：Blanca Heras Pé ; rez^a ; Julio Gobernado Tejedor^a ; ^b ; ^{julio.gobernado@med.uva.es} ; Pablo Mora Cepeda^a ; ^b ; Ana Almaraz Gó ; mez^c
• 关键词：Edad materna ; Patologí ; a gestacional ; Cesá ; rea
• 刊名：Progresos de Obstetricia y Ginecolog铆a
• 出版年：2011
• 期刊代码：pca294_03045013
• 类别：med
• 出版时间：November 2011
• 卷：54
• 期：11
• 页码：575-580
• 文件大小：206 K

Objective

To compare perinatal outcomes in women aged 35 years or over with those in a control group aged less than 35 years.

Design

Historical cohort study.

Setting

Valladolid (Spain).

Methods

Univariate analysis was performed with estimation of relative risks (RR). Variables related to epidemiology, pregnancy course and perinatal outcomes were analyzed.

Results

A total of 1,455 deliveries were analyzed, of which 355 involved women aged 35 years or over (24.39%). Older women more frequently showed pregnancy-associated disorders (29.2 vs 15.8%, p < 0.001): gestational diabetes (6.2%, p < 0.0029), first-trimester metrorrhagia (5.6%, p < 0.01), and risk of preterm birth (3.9%, P < 0.007); pregnancy-induced hypertension was also more frequent in this group but this difference was not statistically significant. Induction of labor was more frequently required in the older group (RR = 1.42; 95%CI:1.08-1.87). Cesarean section was required in 47%of older nulliparous women (RR = 1.63; 95%CI: 1.24-2.15). The overall perinatal mortality rate in older patients was 16.5鈥? compared with 2.77鈥?in the control group. Maternal morbidity was higher in the group of older patients (RR 5.98; 95%CI 1.35-26.54) and mainly consisted of hemorrhagic complications.

Conclusions

Advanced maternal age is associated with a higher frequency of pregnancy-related disorders and a greater incidence of medically-induced delivery and cesarean sections, especially in primiparous mothers. Age therefore influences maternal and fetal morbidity and mortality. Consequently, these women constitute an obstetric risk population requiring special attention which, given the number of older pregnant women, goes beyond the scope of health provisions in our environment.