Very advanced maternal age and morbidity in Victoria, Australia: a population based study.
Very advanced maternal age and morbidity in Victoria, Australia: a population based study.
复制标题
DOI：
10.1186/1471-2393-13-80
复制
发表时间：
2013-03-27
影响因子：
3.1
通讯作者：
Kealy M
中科院分区：
文献类型：
--
作者：
Carolan MC;Davey MA;Biro M;Kealy M
在澳大利亚，大约0.1%的分娩发生在45岁或45岁以上的妇女身上，近年来这一比例一直在上升。然而，很少有以人口为基础的研究，检查围产期的结果在这个年龄组。本研究的目的是确定与30-34岁妇女相比，45岁或以上妇女怀孕的孕产妇和围产期结局。2005年和2006年关于妊娠20周或以上的分娩数据来自维多利亚州围产期数据收集。我们检查了年龄在45岁或以上的高龄产妇（VAMA）（n = 217）的孕产妇和围产期结局，并将其与年龄在30-34岁的妇女（n = 48，909）进行了比较。使用数字和百分比总结数据。分类数据采用卡方检验和Fisher精确检验进行分析。比较采用未校正的比值比、95%置信区间（CI）和p值。45岁及以上的女性发生妊娠期糖尿病（OR 2.05; 95% CI 1.3-3.3）、产前出血（OR 1.89; 95% CI 1.01-3.5）和前置胎盘（OR 4.88; 95% CI 2.4-9.5）的几率较高。年龄较大的组在32-36周（OR 2.61; 95% CI 1.8-3.8）之间早产的几率也较高;低出生体重（<2，500 gr）（OR 2.22; 95% CI 1.5-3.3）和小于胎龄儿（OR 1.53; 95% CI 1.0-2.3）。分层分析显示，VAMA与未产妇（OR 8.24; 95% CI 4.5，15.4）和使用ART的妇女（OR 5.75; 95% CI 2.5，13.3）的剖腹产最密切相关，但无论产次、ART使用和多胎，这种关系都持续存在。低出生体重仅在第一胎与VAMA相关（OR 3.90; 95% CI 2.3，6.6），而早产在老年妇女中更常见，（OR 3.13; 95% CI 1.8，5.3）和随后（OR 2.08; 95% CI 1.2，3.5），单胎分娩（OR 2.11; 95% CI 1.3，3.4），未使用ART（OR 2.10; 95% CI 1.3，3.4）。早产在多胎分娩和使用抗逆转录病毒疗法后非常常见，无论产妇年龄如何。这项研究表明，在澳大利亚维多利亚，45岁及以上的妇女与30-34岁的妇女相比，怀孕和围产期并发症的发生率更高。
In Australia, approximately 0.1% of births occur to women 45 years or older and this rate has been increasing in recent years. There are however, few population based studies examining perinatal outcomes among this age group. The aim of this study was to determine the maternal and perinatal outcomes of pregnancies in women aged 45 years or older compared to women aged 30–34 years. Data on births at 20 or more weeks’ gestation were obtained from the Victorian Perinatal Data Collection for the years 2005 and 2006. We examined selected maternal and perinatal outcomes for women of very advanced maternal age (VAMA) aged 45 years or older (n = 217) and compared them to women aged 30–34 years (n = 48,909). Data were summarised using numbers and percentages. Categorical data were analysed by Chi-square tests and Fisher’s exact test. Comparisons are presented using unadjusted odds ratios, 95 percent confidence intervals (CIs) and p-values. Women aged 45 years and older had higher odds of gestational diabetes (OR 2.05; 95% CI 1.3–3.3); antepartum haemorrhage (OR 1.89; 95% CI 1.01–3.5), and placenta praevia (OR 4.88; 95% CI 2.4–9.5). The older age-group also had higher odds of preterm birth between 32–36 weeks (OR 2.61; 95% CI 1.8–3.8); low birth-weight (<2,500 gr) (OR 2.22; 95% CI 1.5–3.3) and small for gestational age (OR 1.53; 95% CI 1.0–2.3). Stratified analysis revealed that VAMA was most strongly associated with caesarean section in primiparous women (OR 8.24; 95% CI 4.5, 15.4) and those using ART (OR 5.75; 95% CI 2.5, 13.3), but the relationship persisted regardless of parity, ART use and plurality. Low birthweight was associated with VAMA only in first births (OR 3.90; 95% CI 2.3, 6.6), while preterm birth was more common in older women for both first (OR 3.13; 95% CI 1.8, 5.3) and subsequent (OR 2.08; 95% CI 1.2, 3.5) births, and for those having singleton births (OR 2.11; 95% CI 1.3, 3.4), and those who did not use ART (OR 2.10; 95% CI 1.3, 3.4). Preterm birth was very common in multiple births and following ART use, regardless of maternal age. This study demonstrates that women aged 45 years and older, in Victoria, Australia, have higher rates of pregnancy and perinatal complications, compared to women aged 30–34 years.
登录
查看更多内容
DOI：
10.1111/j.1467-842x.2006.tb00109.x
发表时间：
2006-04-01
影响因子：
3.5
作者：
Cameron, CA;Roberts, CL;Fischer, WE
通讯作者：
Fischer, WE
DOI：
10.1111/j.1479-828x.2005.00333.x
发表时间：
2005-02-01
影响因子：
1.7
作者：
Callaway, LK;Lust, K;McIntyre, HD
通讯作者：
McIntyre, HD
影响因子：
6.7
作者：
CANO, F;SIMON, C;PELLICER, A
通讯作者：
PELLICER, A
DOI：
10.1016/j.ejogrb.2003.09.005
发表时间：
2003-11-28
影响因子：
2.6
作者：
Bréart, G;Barros, H;Prati, S
通讯作者：
Prati, S
影响因子：
2
作者：
Balayla, Jacques;Azoulay, Laurent;Abenhaim, Haim A.
通讯作者：
Abenhaim, Haim A.