Premium
Is there an incremental rise in the risk of obstetric intervention with increasing maternal age?
Author(s) -
Rosenthal Adam N.,
PatersonBrown Sara
Publication year - 1998
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.1998.tb09937.x
Subject(s) - medicine , caesarean section , obstetrics , fetal distress , gestational age , vaginal delivery , gestation , population , advanced maternal age , pregnancy , incidence (geometry) , fetus , gynecology , genetics , physics , environmental health , optics , biology
Objective To determine whether increasing maternal age increases the risk of operative delivery and to investigate whether such a trend is due to fetal or maternal factors. Design Analysis of prospectively collected data on a maternity unit database. Setting A postgraduate teaching hospital. Population 6410 nulliparous women with singleton cephalic pregnancies delivering at term (37–42) weeks of gestation) between 1 January 92 and 31 December 95. Main outcome measures Mode of delivery, rates of prelabour caesarean section, induction of labour and epidural usage. Results There was a positive, highly significant association between increasing maternal age and obstetric intervention. Prelabour ( P < 0.001 ) and emergency ( P < 0.001 ) caesarean section, instrumental vaginal delivery (spontaneous labour P < 0.001 ; induced labour P = 0.001 ), induction of labour ( P < 0.001 ) and epidural usage in spontaneous labour ( P = 0.005 ) all increased with increasing age. In the second stage of labour fetal distress and failure to advance, requiring instrumental delivery, were both more likely with increasing maternal age (in both P < 0.001 ). Epidural usage in induced labour and the incidence of small for gestational age newborns did not increase with increasing maternal age (P = 0.68 and P = 0.50 , respectively). Conclusions This study demonstrates that increasing maternal age is associated with an incremental increase in obstetric intervention. Previous studies have demonstrated a significant effect in women older than 35 years of age, but these data show changes on a continuum from teenage years. This finding may reflect a progressive, age‐related deterioration in myometrial function.