Outcome of singleton pregnancy in women ≥45 years old: a retrospective cohort study

Abstract

OBJECTIVE: To investigate prematurity rate in women aged ≥ 45 carrying a singleton pregnancy. Other maternal and neonatal outcomes are also described. DESIGN: Retrospective cohort study. SETTING: Women delivering a singleton pregnancy at a single tertiary medical center. POPULATION: The study included all women aged 45 years and over who delivered at 20 weeks gestation or beyond over a 9-year period from May 2000 to May 2009. METHODS: Women aged 45 years and over were identified. The study group was compared to a control group of women <40 years with singleton pregnancies conceived by in vitro fertilization (IVF) who delivered during the same time period. MAIN OUTCOME MEASURE(S): Maternal complications during pregnancy and neonatal outcome. RESULTS: During the study period 278 women ≥ 45 years delivered a singleton pregnancy. The control group included 304 women. The rate of delivery before 37 weeks as well as before 32 weeks were very high in our study group (18.7 vs. 10.9%, p = 0.009 and 5.4 vs. 2.0%, p = 0.04, respectively). In multivariate analysis, older maternal age was not independently related to prematurity. Chronic hypertension (HTN) was found to be a major risk factor associated with prematurity in advanced maternal age. CONCLUSIONS: Women ≥ 45-years-old with a singleton pregnancy carry a higher risk of maternal and perinatal complications. Preterm birth is a significant complication in this age group and is associated with preexisting chronic HTN.