Comparison of Perception of Pregnancy Risk of Nulliparous Women of Advanced Maternal Age and Younger Age

Introduction: Over the last 3 decades, the proportion of women who have delayed childbearing into their mid 30s and early 40s has been increasing. Because advanced maternal age (AMA) is associated with several adverse maternal, fetal, and neonatal outcomes, these pregnancies are considered to be high risk. Research indicates that pregnancy risk perception is an important factor in pregnant women's health care use and decision making during pregnancy. The objectives of this study were to compare risk perception in pregnant women of AMA (aged 35 years or older) with that of younger women and to explore the relationship between perception of pregnancy risk and selected variables. Methods: A sample of 159 nulliparous pregnant women (105 aged 20-29 years and 54 aged 35 years or older) was recruited from a variety of settings in Winnipeg, Manitoba, Canada. Women were asked to complete questionnaires to assess perception of pregnancy risk, risk knowledge, pregnancy-related anxiety, perceived control, health status, and medical risk. Results: Women of AMA had higher education levels, were more likely to work during pregnancy, and had higher medical risk scores than younger women. Women of AMA perceived higher pregnancy risk for both themselves and their fetuses than did younger women. They rated their risks of cesarean birth, dying during pregnancy, preterm birth, and having a newborn with a birth defect or one needing admission to a neonatal intensive care unit higher than those of younger women. There were no significant differences between the 2 age groups in pregnancy-related anxiety, knowledge of risk, perceived control, and health status. Discussion: Women of AMA have a higher perception of pregnancy risk than younger women, regardless of their medical risk. This evidence suggests that incorporating discussions of pregnancy risk into prenatal care visits may assist pregnant women of AMA to make more informed choices, reduce anxiety, and avoid unnecessary interventions.