Maternal age and fetal loss: population based register Linkage study
Maternal age and fetal loss: population based register Linkage study
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DOI：
10.1136/bmj.320.7251.1708
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发表时间：
2000-06-24
影响因子：
--
通讯作者：
Melbye, M
中科院分区：
文献类型：
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作者：
Andersen, AMN;Wohlfahrt, J;Melbye, M
目的探讨孕妇年龄与胎儿死亡的关系（自然流产，异位妊娠，死产），考虑到妇女的生育史。设计前瞻性登记连锁研究。对象所有妇女的生育结果（活产、死产、自然流产导致住院、人工流产、异位妊娠或葡萄胎）;共634272例妇女和1221546例妊娠结局，主要结局指标为与年龄相关的胎儿丢失、异位妊娠和死胎风险，以及与年龄相关的自然流产风险，根据产次和既往自然流产分层。在42岁时，超过一半的怀孕导致胎儿丢失。20-24岁妇女自然流产的风险为8.9%，45岁或以上妇女为74.7%。无论既往流产次数、产次或日历周期如何，高龄产妇是自然流产的一个重要危险因素。异位妊娠和死产的风险也随着母亲年龄的增加而增加。结论在30多岁或更老的妇女中，胎儿丢失率较高;无论生育史如何。在怀孕计划和咨询中应考虑到这一点。
Objective To estimate the association between maternal age and fetal death (spontaneous abortion, ectopic pregnancy, stillbirth), taking into account a woman's reproductive history.Design Prospective register linkage study.Subjects All women with a reproductive outcome (live birth, stillbirth, spontaneous abortion leading to admission to hospital, induced abortion, ectopic pregnancy, or hydatidiform mole) in Denmark from 1978 to 1992; a total of 634 272 women and 1 221 546 pregnancy outcomes.Main outcome measures Age related risk of fetal loss, ectopic pregnancy, and stillbirth, and age related risk of spontaneous abortion stratified according to parity and previous spontaneous abortions.Results Overall, 13.5% of the pregnancies intended to be carried to term ended with fetal loss. At age 42 years, more than half of such pregnancies resulted in fetal loss. The risk of a spontaneous abortion was 8.9% in women aged 20-24 years and 74.7% in those aged 45 years or more. High maternal age was a significant risk factor for spontaneous abortion irrespective of the number of previous miscarriages, parity, or calendar period. The risk of an ectopic pregnancy and stillbirth also increased with increasing maternal age.Conclusions Fetal loss in high in women in their late 30s or older; irrespective of reproductive history. This should be taken into consideration in pregnancy planning and counselling.