Hum. Reprod. Advance Access originally published online on February 8, 2007
Human Reproduction 2007 22(5):1264-1272; doi:10.1093/humrep/del522
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Elevated risks of pregnancy complications and adverse outcomes with increasing maternal age
1 University of Miami School of Nursing and Health Studies, Coral Gables, and Department of Obstetrics and Gynecology and Department of Pediatrics, Miller School of Medicine, University of Miami, Miami, FL, USA 2 Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, USA
3 To whom correspondence should be addressed at: School of Nursing and Health Studies, University of Miami, 5030 Brunson Drive, Coral Gables, FL 33143, USA. Tel: +1 305 284 6258; Fax: +1 305-284-4370; E-mail: bluke{at}med.miami.edu
BACKGROUND: In the USA, between 1980 and 2004, the proportion of all births increased 2-fold in women aged 
30, 3-fold in women aged 35 and nearly 4-fold in women aged 40. The objective of this study was to evaluate the risks of pregnancy complications and adverse outcomes with increasing maternal age using national vital statistics data.
METHODS: The study population included 8 079 996 live births of singletons of 20 weeks among women aged 30–54 from the 1995–2000 US Birth Cohort Linked Birth/Infant Death Data Set. Outcomes were modelled by maternal age and parity using multinomial logistic regression to calculate adjusted odds ratios (AORs) and 95% confidence intervals.
RESULTS: The risks for most outcomes paralleled increasing maternal age including prolonged and dysfunctional labour, excessive labour bleeding, breech and malpresentation and primary Caesarean delivery. The highest AORs among women aged 45 versus 30–34 by parity (primiparas and multiparas, respectively) were for chronic hypertension (3.70, 4.89), diabetes (2.19, 2.58), primary Caesarean (3.14, 2.85), excessive labour bleeding (1.54, 1.49), pregnancy hypertension (1.55, 2.13) and birth <32 weeks (2.11, 1.77).
CONCLUSIONS: Increasing maternal age is associated with significantly elevated risks for pregnancy complications and adverse outcomes, which vary by parity.
Key words: adverse outcomes/Caesarean birth/maternal age/pregnancy complications
Presented at the 62nd Annual meeting of the American Society for Reproductive Medicine, New Orleans, Lousiana, October 21–25, 2006.
Submitted on October 26, 2006; resubmitted on December 5, 2006; resubmitted on December 14, 2006; accepted on December 27, 2006.
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