Pregnancies in Women Aged 45 Years and Older - a 10-Year Retrospective Analysis in Berlin.

Abstract:

:Introduction Improved fertility treatment options and a change in the socio-cultural concept of family planning, especially in industrialized regions, has led to an increasing number of births by women of advanced maternal age, which is associated with a higher rate of complications. The aim of this study was to analyze pregnancy outcomes in women aged ≥ 45 years in an inner-city German hospital and to compare these results to those of a younger cohort. Materials and Methods Over a 10-year period from January 2004 to May 2015, the pregnancy outcomes of all 186 women aged ≥ 45 years who delivered in our hospital were compared in a 1 : 1 ratio to those of a cohort of 29-year old women. Results The rates of assisted reproduction (34 vs. 3 %), multiple pregnancies (16 vs. 5 %) and cesarean section (59 vs. 29 %) were significantly increased in the study group. There was an increased risk of preterm delivery (28 vs. 11 %), preeclampsia, gestational diabetes and premature rupture of membranes in the advanced maternal age group. Conclusion Advanced maternal age leads to higher rates of fetal and maternal complications. These findings should be taken into account when planning assisted reproduction and obstetrical care in women with advanced maternal age. :Einleitung Die Verbesserungen bei der Auswahl an Fruchtbarkeitsbehandlungen und der soziokulturelle Wandel in der Familienplanung hat, besonders in den industrialisierten Ländern, zu einer zunehmenden Anzahl an Geburten bei Frauen im fortgeschrittenen Alter geführt, was mit einer höheren Komplikationsrate verbunden ist. Ziel dieser Studie war es, den Schwangerschaftsverlauf bei Frauen im Alter von ≥ 45 Jahren zu analysieren, die in einem innerstädtischen deutschen Krankenhaus entbunden hatten, und die Ergebnisse mit denen einer jüngeren Frauenkohorte zu vergleichen. Material und Methoden Die Schwangerschaftsverläufe aller 186 Frauen im Alter von ≥ 45 Jahren, die in unserer Klinik in einem Zeitraum von 10 Jahren zwischen Januar 2004 und Mai 2015 entbunden hatten, wurden in einer 1 : 1-Ratio mit denen einer Kohorte von 29-jährigen Frauen verglichen. Ergebnisse Die Raten für künstliche Befruchtung (34 vs. 3 %), Mehrlingsschwangerschaften (16 vs. 5 %) und Sectio caesarea (59 vs. 29 %) waren signifikant höher in der Gruppe der Spätgebärenden. In der Studiengruppe war das Risiko für Frühgeburten (28 vs. 11 %), Präeklampsie, Gestationsdiabetes und vorzeitigen Blasensprung ebenfalls erhöht. Schlussfolgerung Ein höheres mütterliches Alter bei der Schwangerschaft ist mit höheren Komplikationsraten für Mutter und Kind verbunden. Diesem Ergebnis sollte bei der Planung assistierter Reproduktion sowie bei der geburtshilflichen Planung für Mütter im fortgeschrittenen Alter Rechnung getragen werden.

authors

Rendtorff R,Hinkson L,Kiver V,Dröge LA,Henrich W

doi

10.1055/s-0043-100105

subject

Has Abstract

pub_date

2017-03-01 00:00:00

pages

268-275

issue

3

eissn

0016-5751

issn

1438-8804

journal_volume

77

pub_type

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