Obstetrical outcomes of pregnant women 50 years and older compared to those aged 45-49 years: A systematic review and meta-analysis.
Obstetrical outcomes of pregnant women 50 years and older compared to those aged 45-49 years: A systematic review and meta-analysis.
复制标题
50 岁及以上孕妇与 45-49 岁孕妇的产科结果相比：系统评价和荟萃分析。
DOI：
10.1111/jog.15662
复制
发表时间：
2023
影响因子：
1.6
通讯作者：
Nishijima K.
中科院分区：
文献类型：
--
作者：
Sugai S;Sekizuka T;Haino K;Nonaka T;Sekine M;Yoshihara K;Nishijima K.
目的在本次综述中，我们比较了 50 岁及以上孕妇与 45-49 岁孕妇的临床特征。 ≥45岁孕妇与妊娠相关并发症密切相关，如剖宫产率、妊娠期高血压、妊娠期糖尿病和早产。虽然年龄≥50岁的孕妇被认为风险更高，但45岁和50岁以上孕妇之间妊娠结局的差异尚不清楚。方法我们的来源策略包括使用PubMed、Cochrane对照试验中心注册库和Web of Science数据库来纳入2010年1月1日至2022年9月30日之间发表的研究。研究人群是50岁及以上的孕妇；对照组是45-49岁的孕妇。主要结局是剖宫产、妊娠期高血压、妊娠期糖尿病和早产。次要结局为小于胎龄、5分钟Apgar评分 < 7、新生儿重症监护病房入住（作为新生儿结局）、未产、辅助生殖技术（ART）和多胎妊娠（作为母亲背景）。 结果 50岁及以上人群剖宫产、妊娠期高血压和早产的发生率显着较高；然而，当汇总分析仅限于单胎妊娠时，显着差异就消失了。 ART 更有可能用于 50 岁以上孕妇的受孕。 ≥50岁女性的婴儿更有可能入住NICU。结论两组之间的结局差异明显受到多胎妊娠的影响，因此，生殖医学专家在ART中应以单胎妊娠为目标。
AimIn this review, We compared clinical characteristics of pregnant women aged 50 and older with those aged 45–49. Pregnant women ≥45 years are strongly associated with pregnancy‐related complications, such as cesarean section rate, gestational hypertension, gestational diabetes mellitus, and preterm birth. Although pregnant women ≥50 years are considered more high‐risk, differences in pregnancy outcomes between those over 45 and 50 years of age are unclear.MethodsOur source strategy included using PubMed, the Cochrane Central Register of Controlled Trials, and Web of Science databases to include studies published between January 1, 2010 and September 30, 2022. The study population was pregnant women 50 years and older; the control group was pregnant women aged 45–49 years. Primary outcomes were cesarean section, gestational hypertension, gestational diabetes mellitus, and preterm birth. The secondary outcomes were small‐for‐gestational age, 5‐min Apgar score < 7, neonatal intensive care unit admission (as neonatal outcomes), nulliparity, assisted reproductive technology (ART), and multifetal pregnancy (as maternal backgrounds).ResultsThe incidence of cesarean section, gestational hypertension, and preterm delivery was significantly higher in those 50 years and older; however, significant differences disappeared when pooled analyses were limited to singleton pregnancies. ART was significantly more likely to be used for conception of pregnant women ≥50 years. Infants of women ≥50 years were more likely to be admitted to NICUs.ConclusionsThe differences in outcomes between the two groups are obviously influenced by multiple pregnancies, therefore, reproductive medicine specialists should aim for singleton pregnancies in ART.