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Maternal Age and ELBW
Vohr BR, Tyson JE, Wright LL, et al. Maternal Age, Multiple Birth, and
Extremely Low Birth Weight Infants. The Journal of Pediatrics (April 2009);154:
498-503.e2).
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Objectives. To compare the rates of adverse neurodevelopmental outcome or
death at 18 to 22 months among extremely low birth weight (ELBW) infants born to
mothers ≥40 years to the corresponding rates among infants of younger mothers.
.
Results. The sample consisted of 14 671 live ELBW births divided into
maternal age groups: <20, 20 to 29, 30 to 39, and ≥40 years. Of infants born to
mothers ≥40 years, 20% were multiples. Mothers ≥40 years had high rates of
obstetric interventions and medical morbidities compared with mothers <40 years.
ELBW live births of mothers ≥40 years were 22% more likely to survive and had a
13% decreased risk of neurodevelopmental impairment or death compared with
mothers <20. Multiple birth, however, was associated with a 10% greater risk of
neurodevelopmental impairment or death.
Conclusion. Although mothers ≥40 years had high pregnancy-related
morbidities, we found no overall increased risk of the composite outcome of
death or NDI. Multiple birth, however, was a predictor of all adverse outcomes
examined, regardless of maternal age.
Comments. Statistics show that births rates for women >40 years
continued to increase in recent years. This delayed childbearing has been
attributed to prolonged education, commitment to profession, delayed marriage,
and other personal reasons. The study showed that maternal morbidity rates were
higher among the mothers ≥40 years which were known facts. Interestingly,
authors found that ELBW infants of mothers ≥40 years had a decreased rate of
death and the combined outcome of death or neurodevelopmental impairment (NDI)
compared with ELBW infants of mothers <20 years. There were no independent
effects of maternal age on NDI, with the exception of primiparous mothers ≥40
years. As the authors indicated, the study did not include infants greater than
1000 g and no information on maternal use of ART which may change their results.
SAA
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