Prevalencia e impacto de la edad materna avanzada en la morbimortalidad materna y perinatal en el Hospital Universitario de Lugo

Abstract

Introduction and objectives: there are a few studies in Spain that update the evidence on advanced maternal age as an independent obstetric risk factor. The objective of this study was to determine the prevalence of advanced maternal age (≥35 age) in pregnant women who give birth in a Hospital from Northwestern Spain, and its association with the incidence of maternal-perinatal morbidity, in terms of complications during pregnancy, childbirth and perinatal outcomes. Material and Methods: Retrospective follow-up observational study that included women ≥ 20 years-old who gave birth during 2014 (n=1378). The temporal evolution of maternal age on the day of delivery of pregnant women who gave birth in that hospital in the period 2011-2021 was also analysed. Data were collected from medical records, including socio-demographic characteristics, comorbidities, gestational conditions, and variables related with the delivery and perinatal outcomes. The evolution of the prevalence of advanced maternal age was studied using a joinpoint regression analysis. Multivariable logistic regression analysis was performed to determine the association of advanced maternal age with obstetric and perinatal outcomes. Results: In the lasts years, there has been a progressive and significative increase of pregnant women age 35 or over, going from 35,4% of deliveries attended in 2011 to 45,5% in 20221 (average annual increase 2,1%; 95% IC=1,0%-2,7%). After adjusting for potential confounding factors in the multivariate analysis, advanced maternal age was associated with the likelihood of gestational diabetes (OR=1.84; 95% CI=1,10-3,07), hypothyroidism (OR=2,11; 95% CI=1,17-3,80), lower probability of an eutocic delivery (OR= 0,74; 95% CI=0,56-0,98) and an increased risk of requiring hospital admission ≥4 days (OR=2,91; 95% CI=1,95-4,35). No association was found with C-section’s rate (OR=1,24; 95% CI=0,89-1,72) or with the rest of complications. Conclusions: A high prevalence of pregnant women of advanced maternal age was confirmed which continues to increase. These pregnant women have a significantly higher risk of developing diabetes and gestational hypothyroidism, as well as requiring a longer hospital stay. It is also associated with a lower probability of eutocic deliveries. However, it is not associated with a higher rate of c-sections or with the rest of the complications studied.