高齡產婦比年輕產婦更易合併高危險妊娠

高齡產婦比年輕產婦更易合併高危險妊娠，
包括: 妊娠高血壓，糖尿病，早產，胎兒死亡，剖腹產，產後出血

http://humrep.oxfordjournals.org/content/22/5/1264.full

Elevated risks of pregnancy complications and adverse outcomes with increasing maternal age

1. Barbara Luke1,3 and 
2. Morton B. Brown2

+Author Affiliations

1. ¹University 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. ²Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, USA

1. 3To 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 begin_of_the_skype_highlighting            +1 305 284 6258      end_of_the_skype_highlighting      ; Fax: +1 305-284-4370 begin_of_the_skype_highlighting            +1 305-284-4370 begin_of_the_skype_highlighting            +1 305-284-4370      end_of_the_skype_highlighting      end_of_the_skype_highlighting; E-mail:bluke@med.miami.edu

• Received October 26, 2006.
• Revision requested December 5, 2006.
• Revision received December 14, 2006.
• Accepted December 27, 2006.

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Abstract

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.