Obstetric and perinatal outcomes in women ≥ 40 years of age: Associations with fetal growth disorders

•Women are postponing motherhood at increasing rates, especially in developed countries.•Maternal age ≥ 40 years was associated with poorer obstetric and perinatal outcomes.•Preterm delivery, induced delivery, and elective cesarean sections were significantly more common in women ≥ 40 years age•Intrauterine growth retardation and macrosomia were significantly more common in women ≥ 40 years age

BackgroundEvidence indicates that advanced maternal age is associated with adverse obstetric and perinatal outcomes. The purpose of this study was to evaluate pregnancy outcomes in women of advanced maternal age (≥ 40 years).MethodsUsing a prospective study design, data were collected by the Department of Obstetrics at the San Joan de Deu Hospital of Barcelona during the 1 June 2009 to 31 May 2012 period. The results were compared across three maternal age groups (≥ 40 [n = 654], 35-39 [n = 2781], and < 35 [n = 7893] years).ResultsOf the 11328 births recorded during the study period, pregnancy-related complications were more common in women ≥ 40 years of age. The most common disorder was diabetes (8.5% in the ≥ 40, 5.3% in the 35-39, and 3.0% in the < 35 years age groups). The women ≥ 40 years of age also had significantly more premature births (p = 0.001) and cesarean sections (17% in the ≥ 40, 12.5% in the 35-39, and 7.9% in the < 35-year age groups; p = 0.001). Intrauterine growth retardation was significantly more frequent in women aged ≥ 40 years (17.4% in the ≥ 40, 15% in the 35-39, and 14.0% in the < 35-year age groups; p = 0.03). Fetal macrosomia was significantly more common in women ≥ 40 years (15.4% in the ≥ 40, 12.6% in the 35-39, and 12% in the < 35-year age groups; p = 0.03).ConclusionMaternal age ≥ 40 years was associated with poorer obstetric and perinatal outcomes and increased the risks of cesarean section, intrauterine growth retardation, and fetal macrosomia.