When is advanced maternal age

There is a classification for women who are pregnant over age 35 because many risks increase after this age. Labeling an expecting mother who is 35 as a higher risk from the start can come along with anxiety and stress, but there are also some benefits to being a mother in your mid-thirties and beyond. This episode examines the evidence behind the risks associated with advanced maternal age and what pregnancy over 35 means for you and your baby.

Become a Pregnancy Podcast Premium member or log in to access all articles and episodes ad-free. Pregnant women who were 15—19 years old but not 11—14 years also had significantly elevated odds for severe preeclampsia, eclampsia, postpartum hemorrhage, fetal distress, and poor fetal growth, and lower odds for hypertension and preeclampsia superimposed on pre-existing hypertension.

Odds of complication during labor and delivery for age groups, adjusted for demographics, type of birth, and comorbidities. This study uses large-scale U. The results show that younger and advanced maternal ages at the time of delivery are associated with greater odds of complications even after controlling for demographics, type of birth, and clinical confounders.

Specifically, both younger and older pregnant women were at increased odds of preterm delivery, poor fetal growth, fetal distress, and severe preeclampsia. For some complications, risk patterns differed for younger and older women. Younger women were at increased odds for chorioamnionitis and endometrits, while older women appeared to have decreased or negligible difference in odds for these infections compared to 25—29 year olds.

Older women were at increased odds of hypertension with pregnancy or superimposed preeclampsia while younger women had decreased or negligible difference in odds for these complications versus 25—29 year olds. For the majority of significant associations, odds of complications increased as maternal age shifted in both directions away from the 25—29 year old reference group.

In addition, the number of significant associations between age and complications was relatively comparable in the older age groups as in the younger groups.

Our findings extend the existing scientific literature by underscoring that young age is associated with increased odds of puerperal infection as much as 5-fold increased odds for endometritis among the women who were 11—14 years old.

The odds decrease as the age of woman increases. Bacteria from intrauterine infections during pregnancy can harm the fetus through systemic inflammation a fetal inflammatory response syndrome 40 , 41 and cause damage to multiple organs.

The increased odds for both chorioamnionitis and endometritis could be due to an immature immune system of young women that makes them more susceptible to uterine infection.

Past research using California discharge data similarly found an age-related risk for incidence of eclampsia at the extremes of maternal age. Moreover, the increased risk of hypertension and superimposed preeclampsia that is associated with age is likely due to age-related increases in hypertension that occurs among women of reproductive age which corroborates existing research on this topic.

Our findings confirm the labor and delivery complications that are associated with age at the time of pregnancy and lend support to the proactive delivery of these messages to girls and adult women.

It is important for adult women who are contemplating whether and when to have children, to know the associated risks and complications of delaying childbirth. This is especially timely given the progressive increase in the age of women at childbirth. It is important for pregnant women to receive counseling from their physicians to increase awareness of the signs and symptoms of pregnancy complications.

There are a number of limitations to note in this study. However, our use of recent data might be less impacted by these issues than earlier studies using ICD coding given recent evidence that ICD coding has improved over time. The southern U. In addition, we only present maternal complications that occurred during labor and delivery and selected fetal outcomes, but not maternal antepartum complications. Data on the health outcomes for the neonates were not available and thus not examined.

It is possible that some risk factors included in analysis were under-coded e. Some states do not release codes on substance use. Furthermore, some potential confounders, such as parity and maternal weight, are important to consider when measuring risks for obstetric complications 56 — 67 but were not available in the dataset.

Despite the limitations of this study, using the HCUP NIS enabled us to identify and control for many variables that may contribute to maternal health such as hospital region, medical comorbidities, and other risk factors. This prospective computerized database further reduced the biases of self-report.

We also examined a large population of women, and thus had sufficient power to detect differences between girls and young women i. Our large-scale study notably verifies the labor and delivery complications that are associated with women who are at the extremes of maternal age. Bierut K02 DA Madden receives research support from Merck and Co, Inc.

Bierut is listed as an inventor on Issued U. National Center for Biotechnology Information , U. Matern Child Health J. Author manuscript; available in PMC Jun 1. Patricia A. Cavazos-Rehg , Ph. Krauss , M. Spitznagel , Ph. Olsen , Ph. Peipert , M. Melissa J.

Edward L. Margaret A. Jeffrey F. Author information Copyright and License information Disclaimer. Please address correspondence and reprint requests to: Patricia A. Cavazos-Rehg, Ph. Copyright notice. The publisher's final edited version of this article is available at Matern Child Health J.

See other articles in PMC that cite the published article. Abstract Objective We utilized an updated nationally representative database to examine associations between maternal age and prevalence of maternal morbidity during complications of labor and delivery. Results In analyses that controlled for demographics and clinical confounders, we found that complications with the highest odds among women, 11—18 years of age, compared to 25—29 year old women, included preterm delivery, chorioamnionitis, endometritis, and mild preeclampsia.

Conclusions Our findings underscore the need for pregnant women to be aware of the risks associated with extremes of age so that they can watch for signs and symptoms of such complications. Tags advanced maternal age.

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