The impact of parity on perinatal outcomes in pregnancies complicated by advanced maternal age

Objective: The purpose of this study was to investigate the impact of parity on perinatal outcomes in pregnancies complicated by advanced maternal age. Material and Methods: A total of 11 587 pregnancies were reviewed retrospectively from patient medical records. Singleton pregnancies greater than 24 weeks of gestation were included. The study group consisted of women >= 40 years old at the time of delivery, and the control group consisted of women aged between 20 and 30 years old. Data regarding age, parity, gestational age, mode of delivery, and obstetric and neonatal complications were collected. Firstly, pregnancies >= 40 years and the younger control group were compared altogether with respect to the obstetric and neonatal complications. Secondly, both groups were divided into subgroups according to parity, and a second comparison was made with controls. Results: Mean maternal age in the study and control groups was 43 +/- 2.2 and 24 +/- 2.8 years, respectively. In women >= 40 years old, all of the investigated obstetric and neonatal complications except postpartum haemorrhage and foetal malformations were higher when compared to younger controls (p<0.05). In the nulliparous >= 40 year old group, the most significant complications were preterm delivery (45.3%), low 5-minute Apgar score (15.2%), and neonatal intensive care unit admission (15.2%). On the other hand, in the multiparous group, preeclampsia (16.6%), abruptio placentae (5.1%), foetal demise (7.2%), and macrosomia (9.6%) were found to be significantly higher when compared to controls. Conclusion: The study suggests that pregnancies of maternal age >= 40 years carry increased risks for both neonatal and obstetric complications, and these risks seem to be effected by parity.