Prenatal and Maternal Outcomes in Advanced Maternal Age, a Comparative Study

Association between maternal age and adverse perinatal outcomes in Arba Minch zuria, and Gacho Baba district, southern Ethiopia: a prospective cohort study

Background

Globally, delayed childbearing to the advanced age is a growing option. It is an emerging public health issue in developing countries. Currently, adverse perinatal outcomes significantly increased. A few studies showed the effect of advanced maternal age on adverse perinatal outcomes. However, most used secondary data or chart reviews, and this increases the risk of biases. Besides, there are limited studies in-country Ethiopia as advanced maternal age steadily increased. Therefore, this study aimed to assess the status of advanced maternal age and its effect on perinatal outcomes in the study setting.

Methods

A community-based prospective cohort study was conducted among 709 study participants from October 15, 2018, to September 30, 2019, in Arba Minch zuria, and Gacho Baba district, southern Ethiopia. The data were collected by a pretested interviewer-administered structured Open Data Kit survey tool and analyzed by SPSS version 25. The log-linear regression model was used to compare perinatal outcomes among women aged 20–34 years and ≥ 35 years. The log-likelihood ratio tested for the goodness of fit. In this study, P-value < 0.05 was considered to declare a result as a statistically significant association.

Results

In this study, 209(29.5%) of the women were age group ≥35 years old, and 500(70.5%) were age group from20–34 years old. Stillbirth (β = 0.29, 95%CI: 0.05, 0.52), and neonatal mortality (β = 0.11, 95%CI: 0.01, 0.21) were significantly associated with the advanced maternal age.

Conclusions

Perinatal outcomes such as stillbirth and neonatal mortality were independently associated with advanced maternal age after controlling for possible cofounders. Therefore, different strategies should design for the women who planned to bear child, and information should provide for women who are advanced age or delayed childbearing to alert them.

Antenatal sleep quality associated with perinatal outcomes in women of advanced maternal age

OBJECTIVES

The increasing prevalence of advanced maternal age (AMA) coupled with poor sleep quality among pregnant women makes it important to study their association with perinatal outcomes. However, little is known about the interaction of AMA and maternal antenatal sleep on perinatal outcomes. Here, we examined whether associations between AMA and perinatal outcomes are modified by antenatal sleep quality.

PARTICIPANTS

Data were collected from 446 women, with a singleton pregnancy and no pregnancy complications, who participated in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort study.

MEASUREMENTS

Participants completed the Pittsburgh Sleep Quality Index (PSQI) at 26-28 weeks gestation and had perinatal outcome data collected upon delivery. Interactions between AMA and maternal sleep quality on perinatal outcomes were investigated and where significant, analyses were further stratified by maternal age. All analyses were adjusted for maternal BMI at 26-28 weeks gestation, ethnicity, and maternal education.

RESULTS

Neonates of mothers of AMA and poor sleep quality (PSQI score >5) had increased odds of stay in the neonatal intensive care unit (adjusted odds ratio = 3.53, 95% CI: -1.21 to 10.27) and shorter birth length (adjusted mean difference = -1.05 cm, 95% CI: -1.82 to -0.20), as compared with women of AMA and good sleep quality (PSQI score ≤5). In women <35 years, sleep quality did not associate with perinatal outcomes.

CONCLUSION

Poor sleep quality in women of AMA was associated with neonatal health outcomes. Improving maternal antenatal sleep may potentially improve perinatal outcomes in offspring of women of AMA.