Delivery outcomes for nulliparous women at the extremes of maternal age - a cohort study

作者：Vaughan D A; Cleary B J; Murphy D J^*

来源：BJOG: An International Journal of Obstetrics and Gynaecology , 2014, 121(3): 261-268.

DOI：10.1111/1471-0528.12311

• Age extremes
• caesarean section
• cohort study
• delivery outcomes
• maternal age

ObjectiveTo examine the associations between extremes of maternal age (17years or 40years) and delivery outcomes. %26lt;br%26gt;DesignRetrospective cohort study. %26lt;br%26gt;SettingUrban maternity hospital in Ireland. %26lt;br%26gt;PopulationA total of 36916 nulliparous women with singleton pregnancies who delivered between 2000 and 2011. %26lt;br%26gt;MethodsThe study population was subdivided into five maternal age groups based on age at first booking visit: 17years, 18-19years, 20-34years, 35-39years and women aged 40years. Logistic regression analyses were performed to examine the associations between extremes of maternal age and delivery outcomes, adjusting for potential confounding factors. %26lt;br%26gt;Main outcome measuresPreterm birth, admission to the neonatal unit, congenital anomaly, caesarean section. %26lt;br%26gt;ResultsCompared with maternal age 20-34years, age 17years was a risk factor for preterm birth (adjusted odds ratio [adjOR] 1.83, 95% confidence interval [95% CI] 1.33-2.52). Babies born to mothers 40years were more likely to require admission to the neonatal unit (adjOR 1.35, 95% CI 1.06-1.72) and to have a congenital anomaly (adjOR 1.71, 95% CI 1.07-2.76). The overall caesarean section rate in nulliparous women was 23.9% with marked differences at the extremes of maternal age; 10.7% at age 17years (adjOR 0.46, 95% CI 0.34-0.62) and 54.4% at age 40years (adjOR 3.24, 95% CI 2.67-3.94). %26lt;br%26gt;ConclusionsExtremes of maternal age need to be recognised as risk factors for adverse delivery outcomes. Low caesarean section rates in younger women suggest that a reduction in overall caesarean section rates may be possible.

• 出版日期2014-2