Advanced Maternal Age and the Risk of Cesarean Birth: A Systematic Review
Advanced Maternal Age and the Risk of Cesarean Birth: A Systematic Review
复制标题
DOI：
10.1111/j.1523-536x.2010.00409.x
复制
发表时间：
2010-09-01
影响因子：
2.5
通讯作者：
Heaman, Maureen
中科院分区：
文献类型：
--
作者：
Bayrampour, Hamideh;Heaman, Maureen
背景：高龄产妇怀孕率的增加是同时的意愿吗？剖宫产率的上升。一些研究发现，高龄产妇是剖宫产的一个危险因素。本系统回顾的目的是评估高龄产妇与未产妇和经产妇剖宫产之间的关系。研究方法：为了识别相关研究，我们使用Medline、EMBASE、PsychINFO和CINAHL检索了1995年1月1日至2008年3月1日发表的文献。我们还手动检索了检索到的文献的参考书目，以识别其他相关研究。我们纳入了发达国家的所有队列研究和病例对照研究。使用科克伦协作网的Review Manager软件（5.0）总结数据。结果：21项研究符合纳入标准并被纳入综述。所有研究均表明，与年轻女性相比，对于nullipams和multiplier，高龄产妇剖宫产的风险增加（相对风险为1.39至2.76）。由于我们发现纳入研究的异质性（统计学和临床）极高，因此我们没有提供剖宫产风险的汇总估计值。结论：所有纳入的研究都说明了高龄妇女剖宫产的风险增加。15项研究调整了这种关联的潜在混杂因素，这表明高龄产妇和剖宫产之间可能存在有效和独立的关联。然而，这种风险增加的相关因素在文献中并不完全清楚。（2010年9月3日）
Background: The increasing pregnancy rate at advanced maternal age is contemporaneous will? the increasing rate of cesarean birth. Several studies have found that advanced maternal age is a risk factor for cesarean birth. The objective of this systematic review was to assess the relationship between advanced maternal age and cesarean birth among nulliparous and multiparous women. Methods: To identify relevant studies, we searched the literature for articles published from January 1, 1995 to March I, 2008, using Medline, EMBASE, PsychINFO, and CINAHL We also hand-searched the bibliographies of retrieved articles to identify additional related studie.s. We included all cohort studies and all case-control studies that examined this association in developed countries. The Cochrane Collaboration's Review Manager software (5.0) was used to summarize the data. Results: Twenty-one studies met the inclusion criteria and were included in the review. All studies demonstrated an increased risk of cesarean birth among women at advanced maternal age compared with younger women, for both nullipams and multiparas (relative risk varied from 1.39 to 2.76). Because we found extreme heterogeneity (both statistical and clinical) among the included studies, we did not provide a pooled estimate of the risk of cesarean birth. Conclusions: All included studies illustrated an increased risk of cesarean birth among older women. Fifteen studies adjusted this association for potential con founders, which suggests that a valid and independent association is likely to exist between advanced maternal age and cesarean birth. However, the associated factors for this increased risk are not totally understood in the literature. (BIRTH 37:3 September 2010)