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Obstetric and neonatal outcome in women aged 50 years and up: A collaborative, Nordic population-based study

  • Ali Khatibi
    Affiliations
    Department of Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden

    Department Obstetrics and Gynecology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
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  • Anne-Marie Nybo Andersen
    Affiliations
    Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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  • Mika Gissler
    Affiliations
    Department of Information Services, THL National Institute for Health and Welfare, Helsinki, Finland

    Department of Neurobiology, Care Sciences and Society, Division of Family Medicine, Karolinska Institute, Stockholm, Sweden
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  • Nils-Halvdan Morken
    Affiliations
    Department of Clinical Science, University of Bergen, Bergen, Norway

    Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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  • Bo Jacobsson
    Correspondence
    Corresponding author at: Department of Obstetrics and Gynecology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.
    Affiliations
    Department Obstetrics and Gynecology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden

    Domain of Health Data and Digitalization, Norwegian Institute of Public Health, Oslo, Norway
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      Abstract

      Objectives

      Childbearing at extremely advanced maternal age is a globally increasing trend, but only a few studies have described the outcomes of these pregnancies. The aim of this study was to describe the occurrence of childbearing at age 50 and up in the Nordic countries, as well as to examine the frequency of adverse obstetric and neonatal outcomes.

      Study design

      A descriptive population-based study was designed. Data from 1991 to 2013 were collected from the Medical Birth Registries in Denmark, Finland, Norway and Sweden. We investigated the occurrence of antepartum, delivery and neonatal outcomes.

      Results

      A total of 170 deliveries, in 141 singleton and 29 multiple pregnancies, were identified in mothers aged 50 and up. The highest frequency during this period was 6 per 100,000 deliveries. The prevalence for selected adverse outcomes in singleton pregnancies were: intrauterine fetal death (IUFD) 6%, preeclampsia 4%, preterm delivery 14%, gestational diabetes 8% and cesarean delivery 50%. In multiple pregnancies, the respective prevalence were: IUFD 2%, preeclampsia 22%, preterm delivery 57%, gestational diabetes 10% and cesarean delivery 79%. Pregnancy after assisted reproductive technologies was frequent (29% of singleton and 50% of multiple pregnancies).

      Conclusions

      This study found high frequency of obstetric and neonatal complications at extremely advanced maternal age. Despite a high prevalence of stillbirth in singleton pregnancies in the studied Nordic countries, other complications were less frequent than those previously reported in different populations. Adequate preconception consultation concerning maternal and neonatal hazards is highly recommended in this group of women.

      Keywords

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