Perinatal outcome of women aged 50 years and above

Objective
Pregnancies occurring in women aged 40 or above are increasing in frequency. Nevertheless, little is known about perinatal outcomes of women aged 50 years old and above. The purpose of this study was to evaluate pregnancy outcome in women at extremely advanced maternal age (≥ 50 years).

Study Design
In a population-based cohort study, perinatal outcomes of women aged 50 years and above were compared to pregnancies in women according to maternal age. Deliveries occurred between the years 1991 and 2014 in a tertiary medical center. We excluded multifetal pregnancies and fetuses with congenital anomalies and chromosomal abnormality. Logistic regression models were used to control for confounders.

Results
During the study period 242,771 deliveries were included, of which 234,824 (96.7%) occurred in women aged <40 years, 7321 (3.0%) in women aged 40-44 years, 558 (0.2%) in women aged 45-49 years and 68 (0.03%) occurred in women 50 years old and above. Pregnancy and perinatal complications were significantly higher in women aged 50 years and above (Table 1). A significant linear association was found between older maternal age and hypertensive disorders of pregnancy, gestational diabetes mellitus (GDM), preterm delivery, cesarean sections, lower Apgar scores at 1st and 5th minutes, as well as rates of perinatal mortality (using the chi-square test for trend). Using multiple logistic regression models, controlling for parity, maternal age of 50 years and above was noted as an independent risk factor for GDM and low Apgar scores (Table 2).

Conclusion
Pregnancy at extreme advanced maternal age, of 50 years and above, is independently associated with adverse perinatal outcome.