Premature Babies Group of Thirty Year Old Women
PLoS One. 2018; 13(1): e0191002.
Effect of maternal age on the run a risk of preterm birth: A large cohort written report
Florent Fuchs
ane Sectionalization of Obstetric Medicine, Department of Obstetrics and Gynecology CHU Sainte Justine, Montréal, Québec, Canada
2 Inserm, CESP Eye for research in Epidemiology and Population Health, U1018, Reproduction and child evolution, Villejuif, France
3 Section of Obstetrics and Gynecology CHU Montpellier, 371 Avenue du Doyen Gaston Giraud, Montpellier, France
Barbara Monet
1 Partitioning of Obstetric Medicine, Department of Obstetrics and Gynecology CHU Sainte Justine, Montréal, Québec, Canada
Thierry Ducruet
4 CHU Sainte-Justine Enquiry Center, Université de Montréal, Montréal, Québec, Canada
Nils Chaillet
5 Clinical Research Center Étienne-Le Bel, CHU Sherbrooke, Sherbrooke, Québec, Canada
Francois Audibert
i Division of Obstetric Medicine, Department of Obstetrics and Gynecology CHU Sainte Justine, Montréal, Québec, Canada
Julie Gutman, Editor
Received 2017 May 25; Accepted 2017 December xviii.
- Data Availability Statement
-
The data underlying this written report are restricted by the Research Ethics Board of CHU Sainte-Justine in order to protect participant privacy. Data are bachelor from the IRB of CHU Sainte Justine ac.cq.enitsuj-ets-ehcrehcer@euqihte for researchers who meet the criteria for access to confidential data.
Abstract
Groundwork
Maternal historic period at pregnancy is increasing worldwide as well as preterm birth. Nonetheless, the association between prematurity and advanced maternal age remains controversial.
Objective
To evaluate the affect of maternal age on the occurrence of preterm nativity later decision-making for multiple known confounders in a large nascency cohort.
Report design
Retrospective cohort study using data from the QUARISMA study, a big Canadian randomized controlled trial, which collected data from 184,000 births in 32 hospitals. Inclusion criteria were maternal age over twenty years. Exclusion criteria were multiple pregnancy, fetal malformation and intra-uterine fetal decease. 5 maternal age categories were defined and compared for maternal characteristics, gestational and obstetric complications, and adventure factors for prematurity. Adventure factors for preterm nascency <37 weeks, either spontaneous or iatrogenic, were evaluated for different age groups using multivariate logistic regression.
Results
165,282 births were included in the report. Chronic hypertension, assisted reproduction techniques, pre-gestational diabetes, invasive procedure in pregnancy, gestational diabetes and placenta praevia were linearly associated with increasing maternal age whereas hypertensive disorders of pregnancy followed a "U" shaped distribution according to maternal age. Crude rates of preterm birth before 37 weeks followed a "U" shaped curve with a nadir at 5.vii% for the group of 30–34 years. In multivariate assay, the adjusted odds ratio (aOR) of prematurity stratified past age group followed a "U" shaped distribution with an aOR of ane.08 (95%CI; ane.01–1.xv) for 20–24 years, and i.20 (95% CI; i.06–i.36) for 40 years and older. Confounders establish to have the greatest affect were placenta praevia, hypertensive complications, and maternal medical history.
Conclusion
Even later on aligning for confounders, advanced maternal age (40 years and over) was associated with preterm nascency. A maternal age of 30–34 years was associated with the everyman risk of prematurity.
Introduction
During the terminal decades, a gradual increment of maternal age has been observed worldwide. In the United States, betwixt 1970 and 2006, the proportion of meaning women aged over 35 years has increased almost eight times [1] and therefore researchers accept been interested in outcomes of pregnancy in women of advanced age [2–5]. Pregnancy complications such as placenta praevia, intra-uterine growth restriction or fetal demise, gestational diabetes, hypertensive disorders of pregnancy, and caesarean commitment are well known to be more mutual in older pregnant women [six–10]. Therefore, guidelines have emerged, both in North America and Europe, for the direction of pregnancy in patient with advanced maternal age [11–13].
Preterm nativity is the most important factor determining neonatal morbidity and mortality, and has a major bear upon on it. However, in literature, the clan between prematurity and avant-garde maternal age remains controversial. A study on more than 80,000 women revealed that 36% of the increase in prematurity, between 1990 and 1996 in Canada, was attributable to the modify towards increasing maternal historic period [10]. Various studies have tried to study the specific influence of advanced maternal age after adjustment for hypertensive disorders of pregnancy, maternal medical history or assisted reproduction technologies [9, xiv, 15], but the evidence is all the same alien. Thus, as outlined in a systematic review, further research is needed to determine if advanced maternal age is an independent factor for prematurity[16].
The aim of this study was to evaluate the human relationship betwixt advanced maternal historic period and prematurity (both spontaneous and iatrogenic) after decision-making for multiple confounders.
Materials and methods
This is a retrospective cohort study using information obtained from the QUARISMA randomized controlled trial [17]. QUARISMA was a cluster intervention trial designed to appraise the effectiveness of a complex intervention with groundwork information and audits targeting a general population in terms of safe and sustainable reduction in the rate of caesarean sections. The intervention targeted physicians and nurses, involved audits of indications for cesarean commitment, provision of feedback to health professionals, and implementation of all-time practices. Information technology took place in 32 hospitals in the province of Quebec, Canada, from 2008 to 2011 and enabled to collect data on more than 184 000 pregnancies. Trained staff nerveless information on standardized individual records. In this trial, hospitals were the units of randomization and women were the units of analysis. By designating hospitals equally the units of randomization (clusters), the written report ensured that all women inside a given maternity unit were assigned to the same trial group, thereby reducing the gamble of contamination of the intervention effect. Ideals approval was obtained by the Ethics research lath of CHU Sainte-Justine (Montreal) under the Study Number 2604, for the completion of the trial, for the creation of the database and for the present study.
Inclusion criteria were those of the QUARISMA trial: birth at or later 24 gestational weeks of a fetus weighing >500 grams; and maternal age >20 years. Non-inclusion criteria were multiple pregnancies, fetal malformations and intra-uterine fetal demise.
Five maternal historic period categories were divers: twenty–24, 25–29, 30–34, 35–39 and forty years and older. Groups of age were compared based on maternal history: past drug use, nulliparity, and medical history including chronic hypertension, diabetes mellitus, renal and cardiac disease, thrombophilia, systemic erythematous lupus and inflammatory bowel illness. Characteristics of the current pregnancy were likewise studied: drug use, smoking, use of assisted reproductive technologies, and occurrence of an invasive procedure (chorionic villus sampling or amniocentesis). Additionally, groups of age were also compared according to maternal and obstetrical complications: hypertensive complications (gestational hypertension, pre-eclampsia and eclampsia), gestational diabetes and placenta praevia. All comparisons used chi-square test.
The odds ratios for preterm nativity (<37 weeks) and very preterm birth (< 32 weeks) were calculated for different age groups before and after adjustment by multivariate logistic regression for known gamble factors, maternal characteristics and gestational complications. For these analyses, the reference group corresponded to the group with the lowest rate of prematurity. As our analyses did non focus on the intervention of the primary trial (caesarean department) and since this intervention did not condition the relationship between the explanatory variables and the outcome studied in our paper; we did non performed mixed model analyses accounting for cluster (hospitals).
Preterm nascence <37 weeks was divided into spontaneous and iatrogenic preterm birth. For both conditions, risk factors were studied using multivariate logistic analyses later adjustment on covariates. Iatrogenic commitment was defined as performance of a cesarean delivery before onset of labor or induction of labor using cervical ripening or oxytocin.
Results were considered pregnant when p<0.05. All statistical analyses were performed with the use of SAS software, version 9.3 (SAS Institute)
Results
QUARISMA trial reported the effect of 184,952 deliveries. After exclusions, a total of 165,195 births were finally included in the study and distributed as follows: 24 650 aged twenty–24 years; 59 124 aged 25–29 years; 55 867 aged 30–34 years; 21 416 aged 35–39 years; 4138 aged 40 years or more (Fig 1).
Comparing of excluded (19,757) and included (165,195) births did not show whatever discrepancy regarding maternal distribution of age or maternal characteristics. Risk factors for prematurity past historic period category are presented in Table ane. Compared to the xxx–34 years one-time grouping, the rate of chronic hypertension almost tripled in the >40 years group (4.1% versus 1.4%) and the rate of gestational diabetes more than doubled (xix.4% versus 8.seven%). The rates of pre-existing diabetes, assisted reproductive technologies, invasive process, placenta praevia and obesity too increased with maternal age. The prevalence of hypertensive disorders were college among extreme of ages: the rates of gestational hypertension were everyman in patients aged 30 to 34 years, and the rates of preeclampsia were everyman in patients aged 25 to 34 years.
Table 1
Prevalence of maternal and obstetrical risk factors of prematurity by age grouping.
| Overall | twenty–24 years | 25–29 years | xxx–34 years | 35–39 years | 40 years and over | p value* | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| north | % | n | % | n | % | north | % | northward | % | northward | % | ||
| 165195 | 24650 | 59124 | 55867 | 21416 | 4138 | ||||||||
| Maternal history | |||||||||||||
| Past drug use, n (%) | 3292 | 2,0% | 1107 | four,5% | 1199 | 2,0% | 715 | ane,3% | 231 | i,1% | forty | 1,0% | < .001 |
| Primiparity, n (%) | 71145 | 43,1% | 16095 | 65,3% | 29775 | 50,4% | 18802 | 33,seven% | 5450 | 25,iv% | 1023 | 24,7% | < .001 |
| By medical history | |||||||||||||
| Chronic hypertension, n (%) | 2349 | 1,iv% | 211 | 0,9% | 683 | 1,two% | 792 | 1,4% | 493 | 2,3% | 170 | iv,one% | < .001 |
| Diabetes mellitus without insulin, n (%) | 555 | 0,3% | 32 | 0,1% | 123 | 0,2% | 192 | 0,3% | 167 | 0,8% | 41 | 1,0% | < .001 |
| Diabetes mellitus with insulin, n (%) | 653 | 0,4% | 60 | 0,2% | 230 | 0,4% | 221 | 0,four% | 118 | 0,6% | 24 | 0,6% | < .001 |
| Renal disease, north (%) | 2217 | 1,iii% | 338 | 1,4% | 752 | 1,three% | 736 | 1,3% | 340 | 1,vi% | 51 | 1,two% | .013 |
| Cardiac affliction, due north (%) | 2939 | one,viii% | 419 | 1,vii% | 1057 | ane,8% | 950 | 1,7% | 443 | two,1% | 70 | 1,7% | .010 |
| Thrombophilia, n (%) | 2009 | ane,ii% | 201 | 0,eight% | 652 | 1,one% | 749 | 1,iii% | 323 | 1,5% | 84 | ii,0% | <0.01 |
| Systemic erythematous lupus, due north (%) | 111 | 0,1% | 4 | 0,0% | 33 | 0,one% | 49 | 0,1% | 19 | 0,1% | 6 | 0,1% | < .001 |
| Crohn disease, north (%) | 927 | 0,six% | 88 | 0,4% | 328 | 0,6% | 355 | 0,6% | 134 | 0,6% | 22 | 0,5% | < .001 |
| Characteristics of current pregnancy | |||||||||||||
| Drug use, n (%) | 4290 | two,vi% | 1583 | half-dozen,four% | 1524 | two,6% | 864 | i,5% | 258 | 1,2% | 61 | 1,v% | < .001 |
| Smoking, n (%) | 23820 | xiv,iv% | 6962 | 28,2% | 8675 | 14,7% | 5811 | 10,4% | 1958 | 9,1% | 414 | 10,0% | < .001 |
| Assisted reproductive technologies, n (%) | 2073 | 1,3% | 51 | 0,2% | 452 | 0,8% | 846 | one,v% | 546 | two,5% | 178 | 4,three% | < .001 |
| Invasive procedure, n (%) | 6157 | 3,7% | 213 | 0,9% | 776 | 1,iii% | 1210 | 2,2% | 2762 | 12,ix% | 1196 | 28,9% | < .001 |
| Maternal and obstetrical complications | |||||||||||||
| Hypertensive complications, northward (%) | 11496 | vii,0% | 1854 | vii,5% | 4075 | six,9% | 3516 | 6,three% | 1610 | 7,5% | 441 | 10,7% | < .001 |
| At least i hypertensive complexity | |||||||||||||
| Gestational hypertension without agin criteria | 5415 | 3,3% | 852 | 3,five% | 1993 | three,iv% | 1675 | 3,0% | 714 | 3,three% | 181 | 4,iv% | < .001 |
| Gestational hypertension with adverse criteria | 1360 | 0,8% | 206 | 0,8% | 512 | 0,9% | 415 | 0,7% | 170 | 0,8% | 57 | ane,4% | < .001 |
| Pre-eclampsia without agin criteria | 2536 | ane,5% | 440 | 1,viii% | 847 | 1,4% | 761 | i,4% | 387 | 1,eight% | 101 | 2,4% | < .001 |
| Pre-eclampsia with adverse criteria | 2108 | 1,3% | 342 | 1,4% | 705 | 1,2% | 641 | 1,one% | 321 | one,five% | 99 | two,4% | < .001 |
| Eclampsia | 77 | 0,0% | fourteen | 0,1% | xviii | 0,0% | 24 | 0,0% | 18 | 0,ane% | 3 | 0,i% | .026 |
| Gestational diabetes, n (%) | 13335 | 8,1% | 1152 | 4,7% | 3573 | vi,0% | 4848 | 8,7% | 2960 | thirteen,8% | 802 | 19,four% | < .001 |
| Placenta preavia, n (%) | 1207 | 0,7% | 99 | 0,four% | 328 | 0,6% | 458 | 0,viii% | 266 | one,two% | 56 | 1,iv% | < .001 |
| Obesity (n = 118 347), n (%) | 20954 | 17,vii% | 3204 | 17,viii% | 7417 | 16,nine% | 6896 | 17,4% | 2887 | 20,two% | 550 | 21,four% | < .001 |
Rates of preterm birth <37 weeks and very preterm birth <32 weeks were lowest in the 30–34 years onetime group (five.vii% and 0.6% respectively) and highest in women over 40 years (7.8% and ane.0% respectively) (Table 2 and Fig 2). Crude and adjusted odds ratios (ORs, aORs) for preterm birth, very preterm nascence, iatrogenic and spontaneous preterm delivery before 37 weeks, are presented in Table two. For mothers younger than 24 years and older than 35 years, preterm nascence was significantly more than frequent compared to the reference group (xxx–34 years). There was a trend towards increased risk in women aged 25–29 years. ORs for preterm nascency, extreme preterm birth, and spontaneous preterm nascence in the group of 40 years or more were respectively 1.39 (95% CI 1.24–1.57), ane.68 (95% CI ane.21–one.31) and 1.20 (1.04–1.39). Iatrogenic prematurity was well-nigh twice as common in this grouping (OR 1.91 (95% CI 1.56–2.34)).
Risks of all preterm delivery (spontaneous and iatrogenic) before 37 weeks and adjusted odds ratio according to maternal age categories.
Tabular array 2
Risk of preterm nascence and very preterm nascence co-ordinate to maternal age.
| Overall | 20–24 years | 25–29 years | 30–34 years | 35–39 years | 40 years and over | |
|---|---|---|---|---|---|---|
| N | 165195 | 24650 | 59124 | 55867 | 21416 | 4138 |
| Gestational historic period <32 weeks | ||||||
| Due north (%) | 1120 (0,68%) | 206 (0,84%) | 370 (0,63%) | 340 (0,61%) | 162 (0,76%) | 42 (ane,01%) |
| Crude OR (95% CI) | one.38 (one.16–1.64) | 1.03 (0.89–one.19) | 1.00 | 1.25 (1.03–1.50) | 1.68 (1.21–2.31) | |
| Adjusted OR* (95% CI) | 1.16 (0.97–1.39) | 0.97 (0.83–1.13) | one.00 | 1.14 (0.94–i.38) | 1.33 (0.94–one.86) | |
| Gestational historic period <37 weeks | ||||||
| N (%) | 10085 (6,1%) | 1664 (6,75%) | 3554 (half dozen,01%) | 3202 (5,73%) | 1342 (6,27%) | 323 (7,81%) |
| Rough OR (95% CI) | 1.xix (1.12–1.27) | 1.05 (one.00–1.10) | 1.00 | 1.10 (1.03–1.17) | 1.39 (ane.24–1.57) | |
| Adjusted OR* (95% CI) | 1.08 (1.01–1.fifteen) | i.03 (0.98–i.08) | i.00 | ane.04 (0.97–i.xi) | 1.20 (1.06–1.36) | |
| Spontaneous preterm nascence <37 weeks | 7683 (4,7%) | 1308 (v,3%) | 2797 (4,7%) | 2423 (4,3%) | 941 (4,4%) | 214 (v,2%) |
| Crude OR (95% CI) | 1.23 (i.15–1.32) | i.10 (1.04–i.16) | i.00 | 1.01 (0.94–1.10) | i.20 (one.04–1.39) | |
| Adjusted OR* (95% CI) | 1.09 (1.02–1.eighteen) | one.06 (i.00–1.12) | ane.00 | 0.99 (0.92–1.08) | 1.14 (0.98–1.31) | |
| Iatrogenic preterm nativity < 37 weeks | 2402 (one,5%) | 356 (1,iv%) | 757 (1,3%) | 779 (i,4%) | 401 (1,9%) | 109 (two,half dozen%) |
| Rough OR (95% CI) | i.04 (0.91–1.18) | 0.92 (0.83–one.01) | 1.00 | 1.35 (1.20–one.52) | 1.91 (1.56–2.34) | |
| Adapted OR* (95% CI) | i.02 (0.89–1.17) | 0.92 (0.83–1.02) | one.00 | ane.15 (one.01–1.31) | i.31 (1.05–i.64) |
Afterward aligning for potential confounders, advanced maternal age (forty years and over), compared to the reference group (30–34 years), was associated with preterm nascency <37 weeks and iatrogenic preterm birth (aOR one.xx (95% CI 1.06–one.36) and aOR 1.31 (95% CI 1.05–1.64) respectively). Historic period 35–39 years was also associated with iatrogenic prematurity (aOR one.fifteen (1.01–1.31)). Younger women (xx–24 years) had an increased risk of preterm birth (aOR 1.08 (95% CI 1.01–ane.15) and spontaneous preterm birth (aOR 1.09 (95% CI 1.02–ane.eighteen). Detailed results of the multivariate analysis are presented in Tabular array 3. Placenta praevia and hypertensive disorders were associated with the highest risk for preterm birth <37 weeks, due to the increase risk in iatrogenic preterm birth<37 weeks.
Table 3
Value of adjusted ORs to predict preterm delivery before 32 weeks and 37 weeks.
| Delivery < 32 weeks | Delivery < 37 weeks | |
|---|---|---|
| aOR (95% CI) | aOR (95% CI) | |
| Maternal history | ||
| Past drug use, n (%) | 1.35 (0.96–ane.91) | 1.09 (0.95–1.25) |
| Nulliparity, northward (%) | 1.57 (1.39–1.78) | 1.twenty (ane.15–1.26) |
| Past medical history* | two.44 (two.06–2.88) | 1.82 (ane.70–i.94) |
| Characteristics of current pregnancy | ||
| Smoking, northward (%) | 1.22 (1.03–1.44) | 1.35 (1.28–1.43) |
| Drug employ, n (%) | i.86 (1.38–2.51) | i.fifty (1.34–1.69) |
| Assisted reproductive technologies, n (%) | 1.58 (1.06–two.33) | 1.27 (1.08–1.49) |
| Fetal invasive procedure, north (%) | 1.67 (1.29–2.16) | 1.18 (1.07–1.31) |
| Complications of pregnancy | ||
| Hypertensive disorders, n (%) | 1.66 (1.26–2.19) | 2.07 (1.88–ii.29) |
| Gestational diabetes, n (%) | i.11 (0.91–one.36) | 1.36 (i.28–i.46) |
| Placenta preavia, due north (%) | 7.06 (5.31–9.39) | 7.05 (half-dozen.21–7.99) |
Word
We found that advanced maternal age (twoscore years and over) was associated with an increased run a risk of preterm nativity even after adjustment for confounders. The lowest take chances of prematurity was found in mothers aged 30–34 years. Preterm birth was mainly spontaneous in younger women (20–24 years) whereas it was more oftentimes of iatrogenic origin in women over 40.
Our results are in accordance with those of 2 recently published accomplice studies. Lawlor et al, in a population of Danish women, institute a U shaped relationship between maternal age and gamble of preterm birth, with the lowest risk historic period at 24–30 years [18]. A more recent nationwide register-based cohort report in Finland found that the threshold-ages for preterm nascence was 28 years (OR one.10, ane.02–one.19) [5]. However the authors used unlike inclusion criteria and they did not stratify their results according to the onset of preterm nascence (spontaneous or iatrogenic)
Confounders identified in our written report are known risk factors for prematurity. Placenta praevia, gestational diabetes, medical history, use of assisted reproduction technologies and occurrence of an invasive process were all more common in aged mothers. On the other hand, nulliparity, by drug use and smoking were more prevalent in younger mothers. Furthermore, the prevalence of hypertensive disorders was lowest in eye-anile groups. This distribution of risks factors probably accounts for the "U" shaped distribution of preterm birth chance among historic period groups. By inquiry has already shown that younger mothers tend to accept higher prematurity rates, simply the persistence of this result until xxx years former has rarely been identified [19]. In contrast, some studies accept found a higher risk of preterm birth hazard amidst women of the age group 30–34 years [iii, v, xx–22]. This difference could be explained by variations in socio-demographic or clinical risk factors beyond different studies.
A common hypothesis is that the increased risk of preterm birth among aged mothers is largely explained by early labor induction for medical conditions. All the same, our analysis of iatrogenic versus spontaneous prematurity rates amongst aged mothers does non confirm this hypothesis. Khalil et al. found reverse results in a recent cohort study [23]. This discrepancy could be due to a different definition of iatrogenic preterm nascence. In our study, the variable "iatrogenic preterm nascence" was generated using a combination of other variables describing the method of consecration of labor. Such data are exposed to nomenclature bias past information abstractors, and some preterm births could accept been misclassified. For example, preterm births past caesarean section secondary to preterm premature rupture of membranes could accept been misclassified every bit iatrogenic because of an "elective caesarean department" at 34 or 36 weeks. Iatrogenic preterm births could accept been misclassified as spontaneous if oxytocin induction was confounded with oxytocin augmentation. Nevertheless, in calorie-free of our results, we cannot dominion out that advanced maternal historic period is independently associated with spontaneous prematurity, as McIntyre et al. concluded in a population based cohort report [xx]. Regarding younger women (xx–24 years), we confirmed that preterm birth was mainly spontaneous rather than iatrogenic. Equally most women delay their first pregnancy at a afterwards age, women who notwithstanding become meaning at a young age mainly correspond to low socioeconomic status women with higher risk of medical complication of pregnancy. Even if this study controlled a large number of variables, we could not adjust on educational level or social insurance equally this was not reported in the initial study.
The primary strength of this study is the size of the accomplice with more than than 165 000 patients studied. Furthermore, the sampling represents a broad spectrum of patients, including patients from rural and urban communities across a Canadian province. This prospective cohort nested in a large and well-designed randomized controlled trial immune decision-making for a large number of variables, with a standardized information collection and a strict quality control. Hence, the misreckoning event of data such as the utilize of assisted reproductive technologies and occurrence of an invasive procedure has rarely been studied. Yet these factors are important, with aORs for extreme prematurity of 1.58 (95% IC 1.06–ii.33) and 1.67 (95% IC 1.29–2.16).
This study has some limitations. Some potential confounders could not exist studied. BMI information was missing in 28% of patients, therefore, it was non used in multivariate assay. In the population studied, obesity was more common in advanced maternal age mothers. Previous research has shown that backlog weight is associated with overall prematurity before 32 weeks and induced prematurity before 37 weeks [24]. Thus, controlling for BMI could take yielded different results. Moreover, socio-economic data were not available in the database nosotros used. However, a previous report has shown that in older mothers, the association between maternal historic period and preterm nascence was not explained by a confounding effect of socio-economical status[18]. Another limitation of the study is that we could not conform for history of preterm delivery. Even though this variable was reported in the database, information technology was excluded from the terminal analysis, due to misclassification and lack of reliability subsequently quality command. Even so, it is unlikely that previous preterm delivery would exist more frequent in older women, thus reducing the gamble of a confounding result of previous preterm commitment.
Conclusion
In decision, this report based on a big birth cohort was able to demonstrate that even after adjustment for many potential confounders known to exist associated with preterm birth, advanced maternal age was independently associated with preterm delivery. Women of 30–34 years had the lowest hazard of preterm delivery.
Funding Argument
The author(s) received no specific funding for this piece of work.
Information Availability
The data underlying this study are restricted by the Research Ethics Board of CHU Sainte-Justine in order to protect participant privacy. Information are available from the IRB of CHU Sainte Justine air-conditioning.cq.enitsuj-ets-ehcrehcer@euqihte for researchers who see the criteria for access to confidential data.
References
i. Matthews TJ, Hamilton BE. Delayed childbearing: more than women are having their get-go child later in life. NCHS data brief. 2009;(21):1–8. Epub 2009/08/14. . [PubMed] [Google Scholar]
2. Cnattingius Due south, Forman MR, Berendes HW, Isotalo L. Delayed childbearing and risk of adverse perinatal outcome. A population-based study. JAMA: the journal of the American Medical Association. 1992;268(vii):886–ninety. Epub 1992/08/19. . [PubMed] [Google Scholar]
three. Aldous MB, Edmonson MB. Maternal age at first childbirth and risk of low nascency weight and preterm delivery in Washington State. JAMA: the periodical of the American Medical Association. 1993;270(21):2574–7. Epub 1993/12/01. . [PubMed] [Google Scholar]
5. Klemetti R, Gissler Thou, Sainio S, Hemminki Due east. At what age does the run a risk for adverse maternal and babe outcomes increase? Nationwide register-based study on first births in Finland in 2005–2014. Acta Obstet Gynecol Scand. 2016;95(12):1368–75. doi: 10.1111/aogs.13020 . [PubMed] [Google Scholar]
7. Kenny LC, Lavender T, McNamee R, O'Neill SM, Mills T, Khashan AS. Advanced maternal age and adverse pregnancy outcome: evidence from a large contemporary cohort. PloS one. 2013;8(2):e56583 Epub 2013/02/26. doi: ten.1371/periodical.pone.0056583 ; PubMed Central PMCID: PMCPMC3577849. [PMC gratuitous commodity] [PubMed] [Google Scholar]
8. Salem Yaniv S, Levy A, Wiznitzer A, Holcberg G, Mazor M, Sheiner E. A pregnant linear clan exists between advanced maternal historic period and agin perinatal upshot. Archives of gynecology and obstetrics. 2011;283(four):755–9. Epub 2010/04/09. doi: 10.1007/s00404-010-1459-four . [PubMed] [Google Scholar]
9. Jacobsson B, Ladfors L, Milsom I. Advanced maternal age and adverse perinatal outcome. Obstetrics and gynecology. 2004;104(4):727–33. Epub 2004/10/02. doi: ten.1097/01.AOG.0000140682.63746.be . [PubMed] [Google Scholar]
10. Tough SC, Newburn-Melt C, Johnston DW, Svenson LW, Rose Due south, Belik J. Delayed childbearing and its impact on population rate changes in lower birth weight, multiple birth, and preterm delivery. Pediatrics. 2002;109(iii):399–403. Epub 2002/03/05. . [PubMed] [Google Scholar]
xi. Johnson J-AT, Suzanne. Delayed Kid-Bearing. Journal of obstetrics and gynaecology Canada: JOGC = Journal d'obstetrique et gynecologie du Canada: JOGC. 2012;34(ane):80–93. doi: 10.1016/S1701-2163(16)35138-half-dozen [PubMed] [Google Scholar]
14. Joseph KS, Allen AC, Dodds Fifty, Turner LA, Scott H, Liston R. The perinatal effects of delayed childbearing. Obstetrics and gynecology. 2005;105(six):1410–8. doi: ten.1097/01.AOG.0000163256.83313.36 . [PubMed] [Google Scholar]
fifteen. Chan BC, Lao TT. Effect of parity and avant-garde maternal age on obstetric effect. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics. 2008;102(iii):237–41. Epub 2008/07/09. doi: x.1016/j.ijgo.2008.05.004 . [PubMed] [Google Scholar]
16. Newburn-Cook CV, Onyskiw JE. Is older maternal age a risk factor for preterm nativity and fetal growth restriction? A systematic review. Health care for women international. 2005;26(9):852–75. Epub 2005/x/11. doi: 10.1080/07399330500230912 . [PubMed] [Google Scholar]
17. Chaillet N, Dumont A, Abrahamowicz M, Pasquier JC, Audibert F, Monnier P, et al. A cluster-randomized trial to reduce cesarean commitment rates in Quebec. North Engl J Med. 2015;372(18):1710–21. doi: ten.1056/NEJMoa1407120 . [PubMed] [Google Scholar]
18. Lawlor DA, Mortensen L, Andersen AM. Mechanisms underlying the associations of maternal age with adverse perinatal outcomes: a sibling written report of 264 695 Danish women and their firstborn offspring. International journal of epidemiology. 2011;twoscore(5):1205–xiv. doi: 10.1093/ije/dyr084 . [PubMed] [Google Scholar]
19. Fraser AM, Brockert JE, Ward RH. Clan of young maternal age with adverse reproductive outcomes. The New England journal of medicine. 1995;332(17):1113–7. doi: 10.1056/NEJM199504273321701 . [PubMed] [Google Scholar]
20. McIntyre SH, Newburn-Cook CV, O'Brien B, Demianczuk NN. Effect of older maternal age on the adventure of spontaneous preterm labor: a population-based study. Health care for women international. 2009;30(8):670–89. Epub 2009/07/04. doi: 10.1080/07399330802596473 . [PubMed] [Google Scholar]
21. Koo YJ, Ryu HM, Yang JH, Lim JH, Lee JE, Kim MY, et al. Pregnancy outcomes according to increasing maternal age. Taiwanese journal of obstetrics & gynecology. 2012;51(i):60–v. Epub 2012/04/x. doi: 10.1016/j.tjog.2012.01.012 . [PubMed] [Google Scholar]
22. Berkowitz GS, Blackmore-Prince C, Lapinski RH, Savitz DA. Risk factors for preterm birth subtypes. Epidemiology (Cambridge, Mass). 1998;9(3):279–85. Epub 1998/05/xvi. . [PubMed] [Google Scholar]
23. Khalil A, Syngelaki A, Maiz Due north, Zinevich Y, Nicolaides KH. Maternal age and adverse pregnancy outcome: a cohort report. Ultrasound in obstetrics & gynecology: the official periodical of the International Society of Ultrasound in Obstetrics and Gynecology. 2013;42(6):634–43. Epub 2013/05/01. doi: 10.1002/uog.12494 . [PubMed] [Google Scholar]
24. McDonald SD, Han Z, Mulla Southward, Murphy KE, Beyene J, Ohlsson A. Preterm nascence and low nativity weight amid in vitro fertilization singletons: a systematic review and meta-analyses. European periodical of obstetrics, gynecology, and reproductive biological science. 2009;146(2):138–48. Epub 2009/07/07. doi: ten.1016/j.ejogrb.2009.05.035 . [PubMed] [Google Scholar]
Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5791955/
Belum ada Komentar untuk "Premature Babies Group of Thirty Year Old Women"
Posting Komentar