The relationship between advanced maternal age and adverse pregnancy outcomes

Abstract

Aims: This study aimed to evaluate the impact of advanced maternal age on pregnancy and neonatal outcomes. Methods: In this retrospective study, singleton pregnancies delivered at a tertiary care center between January 2021 and December 2023 were assessed. Participants were divided into two groups based on maternal age at delivery: 18–35 years and >35 years. Maternal and perinatal outcomes were compared between the groups using Chi-square tests. Results: The mean maternal age was 32.12±5.37 years (range: 19–45 years). For women aged ≥35 years, the mean age was 38.27±2.66 years, while for those under 35 years, it was 25.98±4.28 years. No statistically significant differences were observed between the groups in terms of gestational diabetes mellitus, placental abruption, placenta previa, macrosomia, 5th-minute Apgar score, stillbirth, or the need for neonatal intensive care (p>0.05). However, pregnancy-induced hypertensive disorders, preterm birth, and postpartum hemorrhage (PPH) were significantly more common in women over 35 years (p=0.033, p=0.039, and p=0.043, respectively). Maternal age was identified as a significant positive predictor for preterm birth, PPH, and hypertensive disorders of pregnancy, with preterm birth being the most strongly associated. Receiver operating characteristic (ROC) analysis revealed optimal maternal age cutoff values for predicting adverse outcomes as follows: >37 years for preterm birth (AUC=0.687; p33 years for pregnancy-induced hypertensive disorders (AUC=0.633; p=0.006). Conclusion: The risk of pregnancy-induced hypertensive disorders, preterm birth, and PPH increases with maternal age. These findings underscore the need for enhanced antenatal monitoring in women of advanced maternal age.