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    Adverse risks of pregnancy over 40

    A study by Danish investigators shows that pregnancy over 40 is associated with higher risk of specific adverse events but not with congenital malformations or stillbirth. The findings, published in Obstetrics & Gynecology, are from analysis of data on more than 360,000 singleton pregnancies.

    The researchers followed a cohort of 369,516 pregnancies in Denmark from 11 to 14 weeks’ gestation to delivery or termination. Mothers aged ≥ 35 years were divided into two groups—those aged 35 to 39 years and those aged ≥ 40 years—both of which were compared with pregnant women aged 20 to 34 years. The adverse pregnancy outcomes that were examined were chromosomal abnormalities, congenital malformations, miscarriage, stillbirth, and birth before 34 weeks’ gestation.

    Associations between advanced maternal age and adverse pregnancy outcomes were assessed with multivariable logistic regression. The authors also created a risk prediction model with prespecified predicting factors to analyze a composite of adverse pregnancy outcomes.

    Adverse pregnancy outcomes were seen in 10.82% of pregnant women aged ≥ 40 years versus 5.46% of pregnant women aged 20 to 34 years (odds ratio [OR] 2.02, 99.8% CI 1.78-2.29). Comparing the same two groups, the women aged ≥ 40 years had a higher risk of chromosomal abnormalities (3.83% vs 0.56%, OR 7.44 [CI 5.93-9.34]), miscarriage (1.68% vs 0.42%, OR 3.10 [CI 2.19-4.38]) and birth before 34 weeks’ gestation (2.01% vs 1.21% OR 1.66 [CI 1.23-2.24]) but no increased risk of congenital malformations or stillbirth. The model showed that being of advanced age, using assisted reproductive technology, being a nullipara, smoking during pregnancy, and being obese increased the absolute predictive risk of an adverse pregnancy outcome.      

    NEXT - Study: Active surveillance of CIN2 a viable treatment

    Judith M. Orvos, ELS
    Judith M. Orvos, ELS, is an editorial consultant for Contemporary OB/GYN.
    Ben Schwartz
    Ben Schwartz is Associate Editor, Contemporary OB/GYN.


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