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Maternal age and adverse pregnancy outcome: a cohort study
Open accessAbstract
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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“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]
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“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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Poon, L. C., Shennan, A. H., Hyett, J. A., Kapur, A., Hadar, E., Divakar, H., McAuliffe, F. M., Costa, F. D. S., von Dadelszen, P., McIntyre, D. H., et al. (2019) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.12802 · Cited by 1,430
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Metadata
- 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.
- 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
- 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
- bronze
- doi.org
- 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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