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Research Article| Volume 216, P178-183, September 2017

Effect of advanced maternal age on maternal and neonatal outcomes in assisted reproductive technology pregnancies

Published:July 28, 2017DOI:https://doi.org/10.1016/j.ejogrb.2017.07.029
Effect of advanced maternal age on maternal and neonatal outcomes in assisted reproductive technology pregnancies
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      Abstract

      Objectives

      To compare maternal and neonatal outcomes between women with assisted reproductive technologies pregnancy aged <40, 40–44, 45–49, and ≥50 years.

      Study

      Design In a population-level analysis study, all live births by ART identified on birth certificate between 2011 and 2014 were extracted (n = 101,494) using data from the Center for Disease Control and Prevention-National Center for Health Statistics (CDC-NCHS). We investigated and compared maternal and neonatal outcomes based on conditions routinely listed on birth certificates.

      Results

      Of 101,494 ART live births, 79,786 (78.6%), 16,186 (15.9%), 4637 (4.6%), and 885 (0.9%) were delivered by women aged <40, 40–44, 45–49, and ≥50 years, respectively. Comparing to women aged < 40 years, women aged 40–44, 45–49, and ≥50 years were at increased risk for gestational hypertension (aRR: 1.26, 1.55, and 1.61, respectively), gestational diabetes (aRR: 1.23, 1.40, and 1.31, respectively), eclampsia (aRR: 1.49, 1.51, and 2.37, respectively), unplanned hysterectomy (aRR: 2.55, 4.05, and 3.02, respectively), and ICU admission (aRR: 1.64, 2.06, and 2.04, respectively). The prevalence of preterm delivery was slightly higher in women aged 45 and older. (35%, 36.9%, and 40.2% in women aged <40 years, 45–49 years, and ≥50 years, respectively)

      Conclusions

      Advanced age ART was significantly associated with higher rates of maternal morbidities. Except for preterm delivery, neonatal outcomes were similar between ART pregnancies in women aged ≥45 years and younger women. These data should be interpreted with caution because of potential confounding by potentially higher use of donor eggs by older women, the exact rates for which we were unable to ascertain from the available data.

      Keywords

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      Article info

      Publication history

      Published online: July 28, 2017
      Accepted: July 23, 2017
      Received in revised form: June 25, 2017
      Received: April 14, 2017

      Identification

      DOI: https://doi.org/10.1016/j.ejogrb.2017.07.029

      Copyright

      © 2017 Elsevier B.V. All rights reserved.

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