Pregnancy outcomes in women of very advanced maternal age
Pregnancy outcomes in women of very advanced maternal age
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DOI：
10.1111/j.1479-828x.2005.00333.x
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发表时间：
2005-02-01
影响因子：
1.7
通讯作者：
McIntyre, HD
中科院分区：
文献类型：
--
作者：
Callaway, LK;Lust, K;McIntyre, HD
目的：评估非常高级母亲年龄的妇女妊娠超过20周的妊娠结局。设计：回顾性队列研究。设定：两家三级产科医院。人群：45岁以上的妇女在分娩时期的妇女。从1992年1月1日至2001年12月31日的10年期。方法：有关孕产妇，妊娠和新生儿结局的信息。为了进行比较，获得了20-29岁妇女的产科数据库的常规收集数据。分辨率：在10年期间，在76名45岁及45岁以上的76名妇女中，有77例怀孕。有74个活体单生，两套活体双胞胎和一组双胞胎在妊娠20周时死亡。 16名妇女是初次的。 84％的怀孕是自然构想的，53％接受了产前染色体的测定； 53％的妇女没有先前存在的医疗问题，13％的女性患有高血压疾病，其中8％的女性患有妊娠糖尿病。有10个早产和六个邮政分娩。剖腹产率为49％，而20-29岁年龄组为23％（p <0.001）。胎龄的10％的新生儿很小，胎龄为8％。 17％的人需要接受特殊护理托儿所的入院，而6％的人患有先天性异常。结论：本系列的母亲和新生儿结局通常很好。剖腹产率显着提高。总体而言，这项研究令人放心，年龄在45岁及以上的女性具有良好的总体健康和染色体正常的胎儿。
Objective: To assess outcomes for pregnancies progressing beyond 20 weeks' gestation in women of very advanced maternal age.Design: Retrospective cohort study.Setting: Two tertiary level obstetric hospitals.Population: Women aged 45 years or more at the time of delivery over a 10-year period from 1 January 1992 to 31 December 2001.Methods: Information regarding maternal, pregnancy and neonatal outcomes was obtained from the medical records. For comparison, routinely collected data from the obstetric database was obtained for women aged 20-29 years.Results: Seventy-seven pregnancies in 76 women aged 45 years and over were registered in the 10-year period. There were 74 liveborn singletons, two sets of liveborn twins and one set of twins stillborn at 20 weeks' gestation. Sixteen women were primiparous. Eighty-four percent of pregnancies were conceived naturally and 53% underwent prenatal chromosomal determination; 53% of women had no pre-existing medical problems, 13% had hypertensive disorders of pregnancy and 8% of women developed gestational diabetes. There were 10 preterm and six post dates deliveries. The Caesarean section rate was 49%, compared to 23% in the 20-29 years age group (P < 0.001). Ten percent of neonates were small for gestational age, and 8% were large for gestational age. Seventeen percent required admission to the special care nursery and 6% had congenital abnormalities.Conclusions: Maternal and neonatal outcomes in this series were generally good. There was a significantly increased rate of Caesarean section. Overall, this study is reassuring for women aged 45 and over who have good general health and a chromosomally normal fetus.