Obstetrics and Gynecology · 2000 · 243 citations · 14 references
MedicineMaternal HealthObstetricsHigh-risk PregnancyMaternal-fetal MedicinePerinatal EpidemiologyChromosomal AbnormalitiesCongenital AnomaliesCongenital DisordersCongenital MalformationsFetal AnomaliesMaternal Age PatternsChromosomal Abnormalities EpidemiologyChromosomal Abnormality RiskCongenital Anomaly RiskCongenital Cardiac AnomaliesCongenital Malformation RiskMantel-haenszel TestMaternal Age EffectsNumerical Chromosomal Abnormalities
The study examined how maternal age influences the incidence of nonchromosomal fetal malformations. Researchers prospectively catalogued malformations in 102,728 pregnancies, stratified maternal age into seven epochs, and used relative risks, Mantel‑Haenszel chi‑square, and logistic regression adjusting for parity to assess age‑related risks. Older maternal age was associated with higher rates of abnormal karyotypes and, after excluding chromosomal abnormalities, a progressive increase in nonchromosomal malformations—approximately a 1 % additional risk in women 35 + and a 3.95 odds ratio for cardiac defects in women 40 +—with clubfoot and diaphragmatic hernia risks also rising, indicating that advanced age beyond 25 markedly elevates the risk of congenital malformations unrelated to aneuploidy.
To examine the effect of maternal age on incidence of nonchromosomal fetal malformations.Malformations detected at birth or in the newborn nursery were catalogued prospectively for 102,728 pregnancies, including abortions, stillbirths, and live births, from January 1, 1988 to December 31, 1994. Maternal age was divided into seven epochs. Relative risks (RRs) were used to compare demographic variables and specific malformations. The Mantel-Haenszel chi(2) statistic was used to compare age-specific anomalies. Multiple logistic regression analysis was used to adjust for parity.Abnormal karyotypes were significantly more frequent in older women. After excluding infants with chromosomal abnormalities, the incidence of structurally malformed infants also was increased significantly and progressively in women 25 years of age or older. The additional age-related risk of nonchromosomal malformations was approximately 1% in women 35 years of age or older. The odds ratio for cardiac defects was 3.95 in infants of women 40 years of age or older (95% CI 1.70, 9.17) compared with women aged 20-24 years. The risks of clubfoot and diaphragmatic hernia also increased as maternal age increased.Advanced maternal age beyond 25 years was associated with significantly increased risk of fetuses having congenital malformations not caused by aneuploidy.
14
Delayed Childbearing and the Outcome of Pregnancy
Gertrud S. Berkowitz, Mary Louise Skovron, Robert H. Lapinski et al. · New England Journal of Medicine · 1990 · 429 citations
Rates of chromosome abnormalities at different maternal ages.
Mark D. Kilby, M. J. Whittle, Bryan Beattie et al. · BMJ · 1996 · 169 citations · Full text
Medicine, Pediatrics, Surgery +17