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Cited by 439Maternal and Perinatal Health InterventionsPregnancy and preeclampsia studiesGestational Diabetes Research and Management

Maternal age and adverse pregnancy outcome: a cohort study

Open access
Khalil, A., Syngelaki, A., Maiz, N., Zinevich, Y., Nicolaides, K. H.·2013·Ultrasound in Obstetrics & Gynecology
DOI 10.1002/uog.12494
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Abstract

Objective: To examine the association between maternal age and a wide range of adverse pregnancy outcomes after adjustment for confounding factors in obstetric history and maternal characteristics. Methods: This was a retrospective study in women with singleton pregnancies attending the first routine hospital visit at 11 + 0 to 13 + 6 weeks' gestation. Data on maternal characteristics, and medical and obstetric history were collected and pregnancy outcomes ascertained. Maternal age was studied, both as a continuous and as a categorical variable. Regression analysis was performed to examine the association between maternal age and adverse pregnancy outcome including pre‐eclampsia, gestational hypertension, gestational diabetes mellitus (GDM), preterm delivery, small‐for‐gestational age (SGA) neonate, large‐for‐gestational age (LGA) neonate, miscarriage, stillbirth and elective and emergency Cesarean section. Results: The study population included 76 158 singleton pregnancies with a live fetus at 11 + 0 to 13 + 6 weeks. After adjusting for potential maternal and pregnancy confounding variables, advanced maternal age (defined as ≥ 40 years) was associated with increased risk of miscarriage (odds ratio (OR), 2.32 (95% CI, 1.83–2.93); P < 0.001), pre‐eclampsia (OR, 1.49 (95% CI, 1.22–1.82); P < 0.001), GDM (OR, 1.88 (95% CI, 1.55–2.29); P < 0.001), SGA (OR, 1.46 (95% CI, 1.27–1.69); P < 0.001) and Cesarean section (OR, 1.95 (95% CI, 1.77–2.14); P < 0.001), but not with stillbirth, gestational hypertension, spontaneous preterm delivery or LGA. Conclusions: Maternal age should be combined with other maternal characteristics and obstetric history when calculating an individualized adjusted risk for adverse pregnancy complications. Advanced maternal age is a risk factor for miscarriage, pre‐eclampsia, SGA, GDM and Cesarean section, but not for stillbirth, gestational hypertension, spontaneous preterm delivery or LGA. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd.

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  • Older women are more likely to have chronic morbidities prior to conception, such as hypertension, diabetes, and autoimmune diseases.

    “Studies have shown older women are more likely to have chronic morbidities prior to conception, such as hypertension, diabetes, and various autoimmune diseases.”

    From Age-related disparities in national maternal mortality trends: A population-based study (2025) · cites this paper as [35]

  • Pre-existing conditions render older women at greater likelihood of developing peripartum adverse conditions.

    “These pre-existing conditions also render them at greater likelihood of developing peripartum adverse conditions [34, 35].”

    From Age-related disparities in national maternal mortality trends: A population-based study (2025) · cites this paper as [35]

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Authors
Khalil, A., Syngelaki, A., Maiz, N., Zinevich, Y., & Nicolaides, K. H.
Affiliations
  • University College London (GB)
  • King's College Hospital (GB)
  • Fetal Medicine Unit, Obstetrics and Gynecology Service, BioCruces Health Research Institute Hospital Universitario Cruces, University of the Basque Country (UPV/EHU) Barakaldo Spain
Corresponding author
Nicolaides, K. H.
ORCID
Venue
Ultrasound in Obstetrics & Gynecology
Publisher
Wiley
Published
2013-11-24
Volume
42
Issue
6
Pages
634-643
ISSN
  • 0960-7692 (ISSN-L)
  • 1469-0705
DOI
10.1002/uog.12494
OpenAlex
W1684740056
Cited by
439
References
53
Citations by year
2026: 23 · 2025: 37 · 2024: 33 · 2023: 46 · 2022: 39 · 2021: 44 · 2020: 59 · 2019: 40 · 2018: 42 · 2017: 29 · 2016: 27 · 2015: 12 · 2014: 8
FWCI
17.51
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Ultrasound in Obstetrics and Gynecology (publishedVersion)
  • PubMed (publishedVersion)
Funders
Fetal Medicine Foundation (1 037 116, Charity No: 1037116, UK Charity No.: 1037116)
Topics
  • Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
  • Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
Keywords
advanced maternal age, adverse pregnancy outcomes, miscarriage, preeclampsia, gestational hypertension, gestational diabetes mellitus, small for gestational age, large-for-gestational-age neonates, stillbirth, cesarean section, singleton pregnancy, pregnancy risk factors, first-trimester prenatal care, maternal characteristics, obstetric history, individual risk assessment
MeSH terms
Abortion, Spontaneous, Adult, Cesarean Section, Female, Fetal Macrosomia, Humans, Infant, Newborn, Infant, Small for Gestational Age, Maternal Age, Pre-Eclampsia, Pregnancy, Pregnancy Complications, Retrospective Studies, Smoking, Cohort Studies, Multivariate Analysis, Logistic Models, Diabetes, Gestational, Premature Birth, Stillbirth

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