Archives of Gynecology and Obstetrics

, Volume 285, Issue 4, pp 951–957

Perinatal correlates of delayed childbearing in a developing country

Maternal-Fetal Medicine

Abstract

Objective

To evaluate women with delayed childbearing after 35 years and the perinatal profile of their surviving offspring in a low-income country.

Method

A matched case–control study of advanced maternal age (AMA) parturients above 35 years was compared to younger mothers (20–35 years) in an inner-city maternity hospital in southwest Nigeria using conditional logistic regression analysis.

Results

A total of 513 were enlisted as cases matched with 1,539 controls. AMA was associated with marital status, occupation, parity, antenatal care and elective cesarean delivery but significantly less likely to be associated with human-immunodeficiency-virus infection and cephalopelvic disproportion. After adjusting for these maternal factors, AMA was not associated with any adverse perinatal outcomes.

Conclusion

Delayed childbearing after 35 years was generally not associated with adverse pregnancy outcomes in this setting and may be indicative of an appreciable awareness of the potential pregnancy risks resulting in higher uptake of obstetric services by AMA mothers.

Keywords

Delayed childbearing Pregnancy outcomes Elective cesarean delivery Antenatal care Sub-Saharan Africa 

References

  1. 1.
    Usta IM, Nassar AH (2008) Advanced maternal age. Part I: obstetric complications. Am J Perinatol 25:521–534PubMedCrossRefGoogle Scholar
  2. 2.
    van Katwijk C, Peeters LL (1998) Clinical aspects of pregnancy after the age of 35 years: a review of the literature. Hum Reprod Update 4:185–194PubMedCrossRefGoogle Scholar
  3. 3.
    Berkowitz GS, Skovron ML, Lapinski RH, Berkowitz RL (1990) Delayed childbearing and the outcome of pregnancy. N Engl J Med 322:659–664PubMedCrossRefGoogle Scholar
  4. 4.
    Creanga AA, Gillespie D, Karklins S, Tsui AO (2011) Low use of contraception among poor women in Africa: an equity issue. Bull World Health Organ 89:258–266PubMedCrossRefGoogle Scholar
  5. 5.
    Luke B, Brown MB (2007) Elevated risks of pregnancy complications and adverse outcomes with increasing maternal age. Hum Reprod 22:1264–1272PubMedCrossRefGoogle Scholar
  6. 6.
    Cleary-Goldman J, Malone FD, Vidaver J, Ball RH, Nyberg DA, Comstock CH, Saade GR, Eddleman KA, Klugman S, Dugoff L, Timor-Tritsch IE, Craigo SD, Carr SR, Wolfe HM, Bianchi DW, D’Alton M, FASTER Consortium (2005) Impact of maternal age on obstetric outcome. Obstet Gynecol 105(5 Pt 1):983–990PubMedCrossRefGoogle Scholar
  7. 7.
    Windridge KC, Berryman JC (1999) Women’s experiences of giving birth after 35. Birth 26:16–23PubMedCrossRefGoogle Scholar
  8. 8.
    Prysak M, Lorenz RP, Kisly A (1995) Pregnancy outcome in nulliparous women 35 years and older. Obstet Gynecol 85:65–70PubMedCrossRefGoogle Scholar
  9. 9.
    Wang Y, Tanbo T, Abyholm T, Henriksen T (2011) The impact of advanced maternal age and parity on obstetric and perinatal outcomes in singleton gestations. Arch Gynecol Obstet 284:31–37PubMedCrossRefGoogle Scholar
  10. 10.
    Grimes DA, Gross GK (1981) Pregnancy outcomes in black women aged 35 and older. Obstet Gynecol 58:614–620PubMedGoogle Scholar
  11. 11.
    Newburn-Cook CV, Onyskiw JE (2005) Is older maternal age a risk factor for preterm birth and fetal growth restriction? A systematic review. Health Care Women Int 26:852–875PubMedCrossRefGoogle Scholar
  12. 12.
    Hsieh TT, Liou JD, Hsu JJ, Lo LM, Chen SF, Hung TH (2010) Advanced maternal age and adverse perinatal outcomes in an Asian population. Eur J Obstet Gynecol Reprod Biol 148:21–26PubMedCrossRefGoogle Scholar
  13. 13.
    Tabcharoen C, Pinjaroen S, Suwanrath C, Krisanapan O (2009) Pregnancy outcome after age 40 and risk of low birth weight. J Obstet Gynaecol 29:378–383PubMedCrossRefGoogle Scholar
  14. 14.
    Weerasekera DS, Udugama SG (2003) Pregnancy at 40 and over: a case-control study in a developing country. J Obstet Gynaecol 23:625–627PubMedCrossRefGoogle Scholar
  15. 15.
    Seoud MA, Nassar AH, Usta IM, Melhem Z, Kazma A, Khalil AM (2002) Impact of advanced maternal age on pregnancy outcome. Am J Perinatol 19:1–8PubMedCrossRefGoogle Scholar
  16. 16.
    Ziadeh SM (2002) Maternal and outcome in nulliparous women aged 35 and older. Gynecol Obstet Invest 54:6–10PubMedCrossRefGoogle Scholar
  17. 17.
    Larbi RK, Buchmann EJ, Matshidze PR (2000) Pregnancy outcomes in urban black South African women aged 35 years and older. J Obstet Gynaecol 20:259–262PubMedCrossRefGoogle Scholar
  18. 18.
    Ilesanmi AO, Fawole O, Olaleye DO, Arowojolu A (1998) Pregnancy outcome in the elderly primigravidae. J Obstet Gynaecol 18:40–43PubMedCrossRefGoogle Scholar
  19. 19.
    Bayrampour H, Heaman M (2010) Advanced maternal age and the risk of cesarean birth: a systematic review. Birth 37:219–226PubMedCrossRefGoogle Scholar
  20. 20.
    Bianco A, Stone J, Lynch L, Lapinski R, Berkowitz G, Berkowitz RL (1996) Pregnancy outcome at age 40 and older. Obstet Gynecol 87:917–922PubMedCrossRefGoogle Scholar
  21. 21.
    Olusanya BO (2009) Newborns at risk of sensorineural hearing loss in low-income countries. Arch Dis Child 94:227–230PubMedCrossRefGoogle Scholar
  22. 22.
    Olusanya BO, Solanke OA (2009) Maternal and neonatal factors associated with mode of delivery under a universal newborn hearing screening programme in Lagos, Nigeria. BMC Pregnancy Childbirth 9:41PubMedCrossRefGoogle Scholar
  23. 23.
    Hoenig JM, Heisey DM (2001) The abuse of power: the pervasive fallacy of power calculations for data analysis. Am Stat 55:19–24CrossRefGoogle Scholar
  24. 24.
    Olowe SA (1981) Standards of intrauterine growth for an African population at sea level. J Pediatr 99:489–495PubMedCrossRefGoogle Scholar
  25. 25.
    Odibo AO, Nelson D, Stamilio DM, Sehdev HM, Macones GA (2006) Advanced maternal age is an independent risk factor for intrauterine growth restriction. Am J Perinatol 23:325–328PubMedCrossRefGoogle Scholar
  26. 26.
    Delvaux T, Buekens P, Godin I, Boutsen M (2001) Barriers to prenatal care in Europe. Am J Prev Med 21:52–59PubMedCrossRefGoogle Scholar
  27. 27.
    UNAIDS (2008) Report on the global AIDS epidemic: status of the global HIV epidemic. New YorkGoogle Scholar
  28. 28.
    Yaniv SS, Levy A, Wiznitzer A, Holcberg G, Mazor M, Sheiner E (2011) A significant linear association exists between advanced maternal age and adverse perinatal outcome. Arch Gynecol Obstet 283:755–759CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  1. 1.Department of Community Health and Primary Care, College of MedicineUniversity of LagosLagosNigeria
  2. 2.Institute of Child Health and Great Ormond Street Hospital for Children NHS TrustUniversity College LondonLondonUK
  3. 3.Consultant Obstetrician and GynecologistLagos Island Maternity HospitalLagosNigeria

Personalised recommendations