Perinatal Outcomes of Advanced and Extreme Advanced Maternal Age Pregnancies

Aim: Advanced and extremely advanced maternal age (AMA, EAMA) are known to be associated with increased perinatal mortality and morbidity. We aimed to compare the perinatal outcomes of pregnancy in women <35 and >= 35 years of age and also to compare the outcomes between AMA and EAMA pregnancies. Methods: A total of 1202 patients, who had regular antenatal follow-up and gave birth in our clinic between June 2016 and December 2017, were included. The study group consisted of 632 patients aged >= 35 years and control group consisted of 570 patients aged <35 years. Then, the patients were divided into two subgroups; patients aged 35-40 years (n=495) and over 40 years (n=137). Socio-demographic features, delivery characteristics and perinatal outcomes were obtained from the medical records. Perinatal outcomes were compared between patient and control groups and between subgroups. Results: Gestational diabetes (GDM) (p<0.001), preeclampsia (p<0.001), placenta previa (PP) (p=0.03) and intrauterine fetal death (IFD) (p<0.001) were more common in AMA group than in controls. In subgroup analysis, cesarean section rate was higher (p<0.001), IFD (p=0.04), PP (p<0.001), preeclampsia (p<0.001) and GDM (p<0.001) were more common in EAMA group than in AMA group. Conclusion: Adverse perinatal outcomes are more common in AMA and EAMA pregnancies. We suggest that close monitoring of these pregnants in the antenatal period is crucial to avoid adverse outcomes and to prevent perinatal mortality and morbidities.