Skip to main content


Log in

The effects of maternal age and parity on maternal and neonatal outcome

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript



Delayed childbearing is increasingly common; hence, concerns emerge regarding potential for additional risks of delivery at advanced maternal age (AMA; ≥35 years). In this study, we sought to assess impact of AMA and parity on maternal and perinatal outcomes.


In this retrospective single-center study (July 2005 to October 2011), we compared spontaneously-conceived singleton births of AMA mothers with spontaneously-conceived singletons of mothers aged 24–27 years. Maternal outcomes: incidence of diabetes, hypertension, and emergency cesarean sections (ECS). Neonatal outcomes: prematurity, birth weight, incidence of small or large for gestational age infants (SGA/LGA, respectively), low birth weight (LBW), and 5′-Apgar scores. Sub-groupings of maternal age were 35–38, 39–42, or 43–47 years; prematurity as <34 or <37 weeks; AMA parity as primiparous, 2–5 births, 6–9 births, or ≥10 births. Binary logistic regression was used for multivariate analyses.


Of 24,579 eligible women, 11,243 were AMA (14.0 % total singleton births) and 13,336 were aged 24–27 years (16.7 % total singleton births) at delivery. There were no maternal or perinatal deaths. Incidence of maternal hypertension and diabetes was significantly greater in AMA, especially oldest AMA. AMA including primiparous had significantly more ECS than younger including primiparous controls, respectively, and were more likely to deliver LGA neonates. Primiparous AMA women did not have increased incidence of LGA babies but significantly increased incidence of SGA infants.


AMA, especially primiparous, has more adverse maternal and neonatal outcomes than younger women; however, these did not include mortality. Consistent antenatal care may explain this.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others


  1. Astolfi P, Zonta LA (2002) Delayed maternity and risk at delivery. Paediatr Perinat Epidemiol 16(1):67–72

    Article  PubMed  Google Scholar 

  2. Berkowitz GS, Skovron ML, Lapinski RH, Berkowitz RL (1990) Delayed childbearing and the outcome of pregnancy. N Engl J Med 322(10):659–664

    Article  CAS  PubMed  Google Scholar 

  3. Yasin SY, Beydoun SN (1988) Pregnancy outcome at greater than or equal to 20 weeks’ gestation in women in their 40s. A case–control study. J Reprod Med 33(2):209–213

    CAS  PubMed  Google Scholar 

  4. Jonas O, Chan A, Roder D, Macharper T (1991) Pregnancy outcomes in primigravid women aged 35 years and over in South Australia, 1986–1988. Med J Aust 154(4):246–249

    CAS  PubMed  Google Scholar 

  5. Viegas OA, Leong WP, Ahmed S, Ratnam SS (1994) Obstetrical outcome with increasing maternal age. J Biosoc Sci 26(2):261–267

    Article  CAS  PubMed  Google Scholar 

  6. Prysak M, Lorenz RP, Kisly A (1995) Pregnancy outcome in nulliparous women 35 years and older. Obstet Gynecol 85(1):65–70

    Article  CAS  PubMed  Google Scholar 

  7. Luke B, Brown MB (2007) Elevated risks of pregnancy complications and adverse outcomes with increasing maternal age. Hum Reprod 22(5):1264–1272

    Article  PubMed  Google Scholar 

  8. Scholz HS, Haas J, Petru E (1999) Do primiparas aged 40 years or older carry an increased obstetric risk? Prev Med 29(4):263–266

    Article  CAS  PubMed  Google Scholar 

  9. Ziadeh S, Yahaya A (2001) Pregnancy outcome at age 40 and older. Arch Gynecol Obstet 265:30–33

    Article  CAS  PubMed  Google Scholar 

  10. 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):1–8

    Article  PubMed  Google Scholar 

  11. Kozinszky Z, Orvos H, Zoboki T, Katona M, Wayda K, Pál A et al (2002) Risk factors for cesarean section of primiparous women aged over 35 years. Acta Obstet Gynecol Scand 81(4):313–316

    Article  PubMed  Google Scholar 

  12. Yasmeen S, Danielsen B, Moshesh M, Gilbert WM (2005) Is grandmultiparity an independent risk factor for adverse perinatal outcomes? J Matern Fetal Neonatal Med 17(4):277–280

    Article  PubMed  Google Scholar 

  13. Delpisheh A, Brabin L, Attia E, Brabin BJ (2008) Pregnancy late in life: a hospital-based study of birth outcomes. J Womens Health (Larchmt) 17(6):965–970

    Article  Google Scholar 

  14. Laskov I, Birnbaum R, Maslovitz S, Kupferminc M, Lessing J, Many A (2012) Outcome of singleton pregnancy in women ≥45 years old: a retrospective cohort study. J Matern Fetal Neonatal Med 25(11):2190–2193

    Article  PubMed  Google Scholar 

  15. Alshami HA, Kadasne AR, Khalfan M, Iqbal SZ, Mirghani HM (2011) Pregnancy outcome in late maternal age in a high-income developing country. Arch Gynecol Obstet 284(5):1113–1116

    Article  PubMed  Google Scholar 

  16. Yogev Y, Melamed N, Bardin R, Tenenbaum-Gavish K, Ben-Shitrit G, Ben-Haroush A (2010) Pregnancy outcome at extremely advanced maternal age. Am J Obstet Gynecol 203(6):558.e1–7

    Article  PubMed  Google Scholar 

  17. Salem Yaniv S, 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(4):755–759

    Article  PubMed  Google Scholar 

  18. Favilli A, Pericoli S, Acanfora MM, Bini V, Di Renzo GC, Gerli S (2012) Pregnancy outcome in women aged 40 years or more. J Matern Fetal Neonatal Med 25(8):1260–1263

    Article  PubMed  Google Scholar 

  19. Ojule JD, Ibe VC, Fiebai PO (2011) Pregnancy outcome in elderly primigravidae. Ann Afr Med 10(3):204–208

    Article  CAS  PubMed  Google Scholar 

  20. Bayrampour H, Heaman M (2010) Advanced maternal age and the risk of cesarean birth: a systematic review. Birth 37(3):219–226

    Article  PubMed  Google Scholar 

  21. 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(1):31–37

    Article  PubMed Central  PubMed  Google Scholar 

  22. 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(1):21–26

    Article  PubMed  Google Scholar 

  23. Mbugua Gitau G, Liversedge H, Goffey D, Hawton A, Liversedge N, Taylor M (2009) The influence of maternal age on the outcomes of pregnancies complicated by bleeding at less than 12 weeks. Acta Obstet Gynecol Scand 88(1):116–118

    Article  PubMed  Google Scholar 

  24. Glasser S, Segev-Zahav A, Fortinsky P, Gedal-Beer D, Schiff E, Lerner-Geva L (2011) Primiparity at very advanced maternal age (≥45 years). Fertil Steril 95(8):2548–2551

    Article  PubMed  Google Scholar 

  25. Tveit JV, Saastad E, Stray-Pedersen B, Børdahl PE, Frøen JF (2010) Concerns for decreased foetal movements in uncomplicated pregnancies–increased risk of foetal growth restriction and stillbirth among women being overweight, advanced age or smoking. J Matern Fetal Neonatal Med 23(10):1129–1135

    Article  PubMed  Google Scholar 

  26. Olusanya BO, Solanke OA (2012) Perinatal correlates of delayed childbearing in a developing country. Arch Gynecol Obstet 285(4):951–957

    Article  CAS  PubMed  Google Scholar 

  27. de Weger FJ, Hukkelhoven CW, Serroyen J, te Velde ER, Smits LJ (2011) Advanced maternal age, short interpregnancy interval, and perinatal outcome. Am J Obstet Gynecol 204(5):421.e1–9

    Article  PubMed  Google Scholar 

  28. Carolan M, Frankowska D (2011) Advanced maternal age and adverse perinatal outcome: a review of the evidence. Midwifery 27(6):793–801

    Article  PubMed  Google Scholar 

  29. Kale A, Kuyumcuoğlu U, Güzel A (2009) Is pregnancy over 45 with very high parity related with adverse maternal and fetal outcomes? Clin Exp Obstet Gynecol 36(2):120–122

    CAS  PubMed  Google Scholar 

  30. Lisonkova S, Janssen PA, Sheps SB, Lee SK, Dahlgren L (2010) The effect of maternal age on adverse birth outcomes: does parity matter? J Obstet Gynaecol Can 32(6):541–548

    PubMed  Google Scholar 

  31. Juntunen KS, Läärä EM, Kauppila AJ (1997) Grand grand multiparity and birth weight. Obstet Gynecol 90(4 Pt 1):495–499

    Article  CAS  PubMed  Google Scholar 

  32. Sacks DA (2007) Etiology, detection, and management of fetal macrosomia in pregnancies complicated by diabetes mellitus. Clin Obstet Gynecol 50:980–989

    Article  PubMed  Google Scholar 

  33. Akin Y, Cömert S, Turan C, Piçak A, Ağzikuru T, Telatar B (2010) Macrosomic newborns: a 3-year review. Turk J Pediatr 52(4):378–383

    PubMed  Google Scholar 

  34. Kaplan B, Harel L, Neri A, Rabinerson D, Goldman GA, Chayen B (1995) Great grand multiparity—beyond the 10th delivery. Int J Gynaecol Obstet 50:17–19

    Article  CAS  PubMed  Google Scholar 

  35. Schimmel MS, Eidelaman AI, Hammerman C, Zdaka P, Kornblut E (1997) Increased parity and risk of trisomy-21: review of 37,110 live births. BMJ 314:720–721

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  36. Doria-Rose VP, Kim HS, Augustine ET, Edwards KL (2003) Parity and the risk of Down’s syndrome. Am J Epidemiol 158(6):503–508

    Article  PubMed  Google Scholar 

  37. Materna-Kiryluk A, Więckowska B, Wiśniewska K, Borszewska-Kornacka MK, Godula-Stuglik U, Limon J et al (2011) Maternal reproductive history and the risk of isolated congenital malformations. Paediatr Perinat Epidemiol 25(2):135–143

    Article  CAS  PubMed  Google Scholar 

  38. Lubchenco LO, Hansman C, Dressler M, Boyd E (1963) Intrauterine growth as estimated from liveborn birth-weight data at 24 to 42 weeks of gestation. Pediatrics 32:793–800

    CAS  PubMed  Google Scholar 

  39. Laopaiboon M, Lumbiganon P, Intarut N, Mori R, Ganchimeg T, Vogel JP et al (2014) Advanced maternal age and pregnancy outcomes: a multicountry assessment. Br J Obstet Gynecol 121(Suppl 1):49–56

    Article  Google Scholar 

Download references


The authors would like to acknowledge the technical assistance of Ms. Rivka Farkash and Mr. Maymone Dahan of the SZMC Computer Services Department in accessing the archival material.

Conflict of interest

None of the authors have any conflicts of interest to report. No special funding was received for the performance of this study.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Deborah Elstein.

Additional information

This paper was presented (in part) at the Annual Meeting, Society of Pediatric Research, May 2012, Boston, MA USA.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Schimmel, M.S., Bromiker, R., Hammerman, C. et al. The effects of maternal age and parity on maternal and neonatal outcome. Arch Gynecol Obstet 291, 793–798 (2015).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: