Subscribe to RSS
DOI: 10.1055/s-0033-1359716
Spontaneously Conceived Pregnancy after 40: Influence of Age and Obesity on Outcome
Publication History
14 May 2013
02 October 2013
Publication Date:
11 December 2013 (online)
![](https://www.thieme-connect.de/media/ajp/201409/lookinside/thumbnails/10.1055-s-0033-1359716-1.jpg)
Abstract
Objective The aim of the study was to examine pregnancy outcomes of healthy nulliparous women aged ≥ 40 years at delivery.
Study Design The study included 53,480 nulliparous women aged 20 to 29 or ≥ 40 years delivering singleton infants, enrolled in a pregnancy risk assessment program between July 1, 2006, and August 1, 2011. Women reporting medical disorders, tobacco use, or conception with assistive reproductive technology were excluded. Data were grouped by body mass (obese or nonobese) and age (20–29 or ≥ 40 years). Pregnancy outcomes were compared within each body mass group for women aged 20 to 29 years versus ≥ 40 years and between obese and nonobese women aged ≥ 40 years.
Results Within each body mass group, nulliparous women aged ≥ 40 years delivered at a significantly lower gestational age and had a greater incidence of cesarean delivery, gestational diabetes, preterm birth, and both low and very low birth weight infants, compared with controls aged 20 to 29 years. For women aged ≥ 40 years, obesity was associated with higher rates of adverse pregnancy outcomes.
Conclusion In healthy women, both advanced maternal age and obesity negatively influence pregnancy outcomes. Women who delay pregnancy until age 40+ years may modify their risk for cesarean section, preterm birth, and low-birth-weight infants by reducing their weight to nonobese levels before conception.
Note
This study was presented at the 60th Annual Clinical Meeting of the American College of Obstetricians and Gynecologists in San Diego, CA, May 7, 2012.
-
References
- 1 Hamilton BE, Martin JA, Ventura SJ. Births: preliminary data for 2011. National Vital Statistics Reports; Vol. 61, no 5. Hyattsville, MD: National Center for Health Statistics; 2012
- 2 Cleary-Goldman J, Malone FD, Vidaver J , et al; FASTER Consortium. Impact of maternal age on obstetric outcome. Obstet Gynecol 2005; 105 (5, Pt 1) 983-990
- 3 Gilbert WM, Nesbitt TS, Danielsen B. Childbearing beyond age 40: pregnancy outcome in 24,032 cases. Obstet Gynecol 1999; 93 (1) 9-14
- 4 Bianco A, Stone J, Lynch L, Lapinski R, Berkowitz G, Berkowitz RL. Pregnancy outcome at age 40 and older. Obstet Gynecol 1996; 87 (6) 917-922
- 5 Ziadeh SM. Maternal and perinatal outcome in nulliparous women aged 35 and older. Gynecol Obstet Invest 2002; 54 (1) 6-10
- 6 Montan S. Increased risk in the elderly parturient. Curr Opin Obstet Gynecol 2007; 19 (2) 110-112
- 7 Flegal KM, Carroll MD, Kit BK, Ogden CL. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010. JAMA 2012; 307 (5) 491-497
- 8 Gunatilake RP, Perlow JH. Obesity and pregnancy: clinical management of the obese gravida. Am J Obstet Gynecol 2011; 204 (2) 106-119
- 9 Joy S, Istwan N, Rhea D, Desch C, Stanziano G. The impact of maternal obesity on the incidence of adverse pregnancy outcomes in high-risk term pregnancies. Am J Perinatol 2009; 26 (5) 345-349
- 10 Mighty HE, Fahey AJ. Obesity and pregnancy complications. Curr Diab Rep 2007; 7 (4) 289-294
- 11 Doherty DA, Magann EF, Francis J, Morrison JC, Newnham JP. Pre-pregnancy body mass index and pregnancy outcomes. Int J Gynaecol Obstet 2006; 95 (3) 242-247
- 12 Athukorala C, Rumbold AR, Willson KJ, Crowther CA. The risk of adverse pregnancy outcomes in women who are overweight or obese. BMC Pregnancy Childbirth 2010; 10: 56
- 13 Ziadeh S, Yahaya A. Pregnancy outcome at age 40 and older. Arch Gynecol Obstet 2001; 265 (1) 30-33
- 14 Jahromi BN, Husseini Z. Pregnancy outcome at maternal age 40 and older. Taiwan J Obstet Gynecol 2008; 47 (3) 318-321