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Pregnancy outcome in women aged 40 years or more.
MedLine Citation:
PMID:  22122237     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Abstract Objective: the study aimed to analyse the pregnancy outcome of women aged 40 or more. Methods: a matched retrospective cohort study comparing women aged 40 or more with a control group aged 20-30 years is described. Multivariate logistic regression models were fitted for the prediction of pre-term birth and cesarean delivery. Results: pregnancy-induced hypertension, pre-eclampsia and placenta previa were similar in both groups, but a higher rate of gestational diabetes was found in elderly patients (OR 3.820, 95% CI = 1.400-10.400; p < 0.0001). Pre-term delivery was significantly more frequent in elderly women (OR 1.847, 95% CI = 1.123-3.037, p = 0.020). Gestational diabetes and pregnancy induced hypertension were strongly associated with preterm delivery and advanced maternal age was not an independent risk factor for preterm delivery. The cesarean delivery rate was significantly higher in the study group (OR 3.234, 95% CI = 2.266-4.617; p < 0.0001). The variables most influencing the caesarean delivery rate were maternal age, analgesia, parity, PROM and gestational hypertension. No significant differences were detected in neonatal birth weight and Apgar score. Conclusions: patients aged 40 or more have been demonstrated to carry a favorable pregnancy and neonatal outcome, similar to younger patients. The risk of cesarean delivery was higher in patients with advanced maternal age, in nulliparous and in women with a previous cesarean section. The risk of preterm delivery was not related to age but it was strongly associated with gestational diabetes and pregnancy induced hypertension.
Authors:
Alessandro Favilli; Silvia Pericoli; Marta Maddalena Acanfora; Vittorio Bini; Gian Carlo Di Renzo; Sandro Gerli
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-11-29
Journal Detail:
Title:  The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians     Volume:  -     ISSN:  1476-4954     ISO Abbreviation:  -     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Obstetrics and Gynecology, University of Perugia, S.M. della Misericordia Hospital, 06156 Perugia, Italy.
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