The impact of advanced maternal age on the outcome of twin pregnancies
- 176 Downloads
To assess the effect of advanced maternal age on the obstetrics and neonatal outcome of twin pregnancies.
A retrospective study of 716 dichorionic–diamniotic twin pregnancies delivered at our institute. The study population was divided into two groups: women aged 35–39 years (group A, n = 142) and women aged ≥ 40 years (Group B, n = 48). The control group consisted of women younger than 35 years (group C, n = 516).
The rate of cesarean section (CS) was significantly higher among women older than 35 years compared to the control group (A 76.8% and B 87.5% vs C 65.7%, P = 0.001). Women older than 35 years were also at higher risk for developing hypertensive disorders (A 7.0%, B 14.6%, vs C 5.4%, P = 0.04). On multivariate regression analysis, maternal age was found to be independently associated with a higher rate of CS (odds ratio vs reference group C: group A 1.6, 95% CI 1.08–2.6; group B 3.2, 95% CI 1.3–7.8). There was no difference between the groups in the rate of neonatal complications.
Women with twin pregnancy, older than 35 years, have a significantly higher rate of CS and hypertensive disorder. This rate increases with maternal age, with no increased rate of neonatal complications.
KeywordsTwin pregnancy Advanced maternal age Neonatal outcome
OG: manuscript writing and project development. YM: data analysis and data collection. JB: data collection and project development. GB: project development and manuscript editing.
This study was not funded.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
For this type of study, formal consent is not required.
Human and animal rights statement
This article does not contain any studies with animals performed by any of the authors.
- 2.The American College of Obstetricians and Gynecologists (2014) Practice Bulletin No 144: Multifetal Gestations: Twin, Triplet, and Higher-Order Multifetal Pregnancies. Obstet Gynecol 123(5):1118–1132. https://doi.org/10.1097/01.AOG.0000446856.51061.3e CrossRefGoogle Scholar
- 3.Martin JA, Hamilton BE, Osterman MJK (2012) Three decades of twin births in the United States, 1980–2009. NCHS Data Brief 80:1–8Google Scholar
- 4.Berkowitz GS, Skovron ML, Lapinski RH, Berkowitz RL (2017) Delayed childbearing and the outcome of pregnancy. N Engl J Med 322(10):659–664. http://www.ncbi.nlm.nih.gov/pubmed/2304491. Accessed 11 Aug 2017
- 5.Balasch J, Gratacós E (2017) Delayed childbearing. Curr Opin Obstet Gynecol 24(3):187–193. http://www.ncbi.nlm.nih.gov/pubmed/22450043. Accessed 11 Aug 2017
- 6.Cnattingius S, Forman MR, Berendes HW, Isotalo L (2017) Delayed childbearing and risk of adverse perinatal outcome. A population-based study. JAMA 268(7):886–890. http://www.ncbi.nlm.nih.gov/pubmed/1640617. Accessed 11 Aug 2017
- 7.Conde-Agudelo A, Belizán JM, Lindmark G (2017) Maternal morbidity and mortality associated with multiple gestations. Obstet Gynecol 95(6 Pt 1):899–904. http://www.ncbi.nlm.nih.gov/pubmed/10831988. Accessed 11 Aug 2017
- 9.Barda G, Gluck O, Mizrachi Y, Bar J (2017) A comparison of maternal and perinatal outcome between in vitro fertilization and spontaneous dichorionic–diamniotic twin pregnancies. J Matern Neonatal Med 1–7. http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L614071469%5Cnhttp://dx.doi.org/10.1080/14767058.2016.1270934%5Cnhttp://sfx.library.uu.nl/utrecht?sid=EMBASE&issn=14764954&id=doi:10.1080%2F14767058.2016.1270934&atitle=A+comparison+Google Scholar
- 13.American College of Obstetricians and Gynecologists (2017) Committee opinion no. 559. Obstet Gynecol 121(4):904–907. http://www.ncbi.nlm.nih.gov/pubmed/23635708. Accessed 11 Aug 2017
- 15.Sekhon LH, Gerber RS, Rebarber A, Saltzman DH, Klauser CK, Gupta S et al (2017) Effect of oocyte donation on pregnancy outcomes in in vitro fertilization twin gestations. Fertil Steril 101(5):1326–1330. http://www.ncbi.nlm.nih.gov/pubmed/24602755. Accessed 12 Aug 2017
- 16.Schimmel MS, Bromiker R, Hammerman C, Chertman L, Ioscovich A, Granovsky-Grisaru S et al (2017) The effects of maternal age and parity on maternal and neonatal outcome. Arch Gynecol Obstet 291(4):793–798. http://www.ncbi.nlm.nih.gov/pubmed/25227657. Accessed 11 Aug 2017
- 17.ACOG Committee on Obstetric Practice (2016) ACOG practice bulletin. Diagnosis and management of preeclampsia and eclampsia. Number 33, January 2002. American College of Obstetricians and Gynecologists. Int J Gynaecol Obstet 77(1):67–75. http://www.ncbi.nlm.nih.gov/pubmed/12094777. Accessed 9 Sep 2016
- 18.Kathiresan A, Roca L, Istwan N, Desch C, Cordova Y, Tudela F et al (2017) The influence of maternal age on pregnancy outcome in nulliparous women with twin gestation. Am J Perinatol 28(5):355–360. http://www.ncbi.nlm.nih.gov/pubmed/21136347. Accessed 12 Aug 2017