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Maternal and neonatal outcomes of spontaneously conceived pregnancies in mothers over 45 years: a review of the literature.

By: Contributor(s): Publication details: 2012ISSN:
  • 09320067
Uniform titles:
  • Archives of Gynecology and Obstetrics
Online resources: Summary: <div style="line-height: 17.999801635742188px;"><h4 style="font-size: 1em; font-family: arial, helvetica, clean, sans-serif; margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left;">PURPOSE:</h4><p style="margin: 0px 0px 0.5em;"><span style="font-size: 8pt;">There is little published data on&nbsp;<span class="highlight">pregnancy</span>&nbsp;<span class="highlight">outcomes</span>&nbsp;in women who had&nbsp;<span class="highlight">conceived</span>&nbsp;<span class="highlight">spontaneously</span>&nbsp;after age&nbsp;<span class="highlight">45</span>&nbsp;<span class="highlight">years</span>. The aim of this<span class="highlight">review</span>&nbsp;is to provide accurate information on the risks and probable&nbsp;<span class="highlight">outcomes</span>&nbsp;of&nbsp;<span class="highlight">spontaneously</span>&nbsp;<span class="highlight">conceived</span>&nbsp;<span class="highlight">pregnancies</span>&nbsp;in women&nbsp;<span class="highlight">over</span>&nbsp;the age of&nbsp;<span class="highlight">45</span><span class="highlight">years</span>, which will enable clinicians to counsel such women appropriately, carry out adequate risk assessment, and ensure better care for&nbsp;<span class="highlight">pregnancies</span>in this population.</span></p><h4 style="margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left;"><span style="font-size: 8pt;">DESIGN:</span></h4><p style="margin: 0px 0px 0.5em;"><span style="font-size: 8pt;">A&nbsp;<span class="highlight">literature</span>&nbsp;search was performed using EmBase and PubMed for English language articles published between 1970 and 2011, with extractable data on&nbsp;<span class="highlight">mothers</span>&nbsp;aged ≥<span class="highlight">45</span>&nbsp;at the time of delivery and with ≥95% spontaneous conception in the study population.</span></p><h4 style="margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left;"><span style="font-size: 8pt;">RESULTS:</span></h4><p style="margin: 0px 0px 0.5em;"><span style="font-size: 8pt;">Six such studies with a total pooled number of 505 women were identified. Overall, there is increased&nbsp;<span class="highlight">maternal</span>&nbsp;morbidity and rates of caesarean section, as well as higher incidence of premature births and admission to special care baby unit. Contrary to popular belief, career is not always an important factor in delaying childbearing, especially in developing countries. Other factors may include cultural acceptance of large families and lack of contraception, although more research may be carried out in order to explain these hypotheses.</span></p><h4 style="margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left;"><span style="font-size: 8pt;">CONCLUSION:</span></h4><p style="margin: 0px 0px 0.5em;"><span style="font-size: 8pt;">Pooled retrospective data suggest that women who&nbsp;<span class="highlight">conceived</span>&nbsp;<span class="highlight">spontaneously</span>&nbsp;after the age of&nbsp;<span class="highlight">45</span>&nbsp;<span class="highlight">years</span>&nbsp;have increased&nbsp;<span class="highlight">maternal</span>morbidity and rates of caesarean section, as well as higher incidence of premature births and admission to special care baby unit.</span></p></div>
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&lt;div style="line-height: 17.999801635742188px;"&gt;&lt;h4 style="font-size: 1em; font-family: arial, helvetica, clean, sans-serif; margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left;"&gt;PURPOSE:&lt;/h4&gt;&lt;p style="margin: 0px 0px 0.5em;"&gt;&lt;span style="font-size: 8pt;"&gt;There is little published data on&amp;nbsp;&lt;span class="highlight"&gt;pregnancy&lt;/span&gt;&amp;nbsp;&lt;span class="highlight"&gt;outcomes&lt;/span&gt;&amp;nbsp;in women who had&amp;nbsp;&lt;span class="highlight"&gt;conceived&lt;/span&gt;&amp;nbsp;&lt;span class="highlight"&gt;spontaneously&lt;/span&gt;&amp;nbsp;after age&amp;nbsp;&lt;span class="highlight"&gt;45&lt;/span&gt;&amp;nbsp;&lt;span class="highlight"&gt;years&lt;/span&gt;. The aim of this&lt;span class="highlight"&gt;review&lt;/span&gt;&amp;nbsp;is to provide accurate information on the risks and probable&amp;nbsp;&lt;span class="highlight"&gt;outcomes&lt;/span&gt;&amp;nbsp;of&amp;nbsp;&lt;span class="highlight"&gt;spontaneously&lt;/span&gt;&amp;nbsp;&lt;span class="highlight"&gt;conceived&lt;/span&gt;&amp;nbsp;&lt;span class="highlight"&gt;pregnancies&lt;/span&gt;&amp;nbsp;in women&amp;nbsp;&lt;span class="highlight"&gt;over&lt;/span&gt;&amp;nbsp;the age of&amp;nbsp;&lt;span class="highlight"&gt;45&lt;/span&gt;&lt;span class="highlight"&gt;years&lt;/span&gt;, which will enable clinicians to counsel such women appropriately, carry out adequate risk assessment, and ensure better care for&amp;nbsp;&lt;span class="highlight"&gt;pregnancies&lt;/span&gt;in this population.&lt;/span&gt;&lt;/p&gt;&lt;h4 style="margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left;"&gt;&lt;span style="font-size: 8pt;"&gt;DESIGN:&lt;/span&gt;&lt;/h4&gt;&lt;p style="margin: 0px 0px 0.5em;"&gt;&lt;span style="font-size: 8pt;"&gt;A&amp;nbsp;&lt;span class="highlight"&gt;literature&lt;/span&gt;&amp;nbsp;search was performed using EmBase and PubMed for English language articles published between 1970 and 2011, with extractable data on&amp;nbsp;&lt;span class="highlight"&gt;mothers&lt;/span&gt;&amp;nbsp;aged ≥&lt;span class="highlight"&gt;45&lt;/span&gt;&amp;nbsp;at the time of delivery and with ≥95% spontaneous conception in the study population.&lt;/span&gt;&lt;/p&gt;&lt;h4 style="margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left;"&gt;&lt;span style="font-size: 8pt;"&gt;RESULTS:&lt;/span&gt;&lt;/h4&gt;&lt;p style="margin: 0px 0px 0.5em;"&gt;&lt;span style="font-size: 8pt;"&gt;Six such studies with a total pooled number of 505 women were identified. Overall, there is increased&amp;nbsp;&lt;span class="highlight"&gt;maternal&lt;/span&gt;&amp;nbsp;morbidity and rates of caesarean section, as well as higher incidence of premature births and admission to special care baby unit. Contrary to popular belief, career is not always an important factor in delaying childbearing, especially in developing countries. Other factors may include cultural acceptance of large families and lack of contraception, although more research may be carried out in order to explain these hypotheses.&lt;/span&gt;&lt;/p&gt;&lt;h4 style="margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left;"&gt;&lt;span style="font-size: 8pt;"&gt;CONCLUSION:&lt;/span&gt;&lt;/h4&gt;&lt;p style="margin: 0px 0px 0.5em;"&gt;&lt;span style="font-size: 8pt;"&gt;Pooled retrospective data suggest that women who&amp;nbsp;&lt;span class="highlight"&gt;conceived&lt;/span&gt;&amp;nbsp;&lt;span class="highlight"&gt;spontaneously&lt;/span&gt;&amp;nbsp;after the age of&amp;nbsp;&lt;span class="highlight"&gt;45&lt;/span&gt;&amp;nbsp;&lt;span class="highlight"&gt;years&lt;/span&gt;&amp;nbsp;have increased&amp;nbsp;&lt;span class="highlight"&gt;maternal&lt;/span&gt;morbidity and rates of caesarean section, as well as higher incidence of premature births and admission to special care baby unit.&lt;/span&gt;&lt;/p&gt;&lt;/div&gt;

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