Subscribe to RSS
Advanced Maternal Age and the Risk of Major Congenital Anomalies
07 April 2016
08 June 2016
11 July 2016 (online)
Objective This study aims to determine if advanced maternal age (AMA) is a risk factor for major congenital anomalies, in the absence of aneuploidy.
Study Design Retrospective cohort study of all patients with a singleton gestation presenting for second trimester anatomic survey over a 19-year study period. Aneuploid fetuses were excluded. Study groups were defined by maternal age ≤ 34 and ≥ 35 years. The primary outcome was the presence of one or more major anomalies diagnosed at the second trimester ultrasound. Univariable and multivariable logistic regression analyses were used to estimate the risk of major anomalies in AMA patients.
Results Of 76,156 euploid fetuses, 2.4% (n = 1,804) were diagnosed with a major anomaly. There was a significant decrease in the incidence of major fetal anomalies with increasing maternal age until the threshold of age 35 (p < 0.001). Being AMA was significantly associated with an overall decreased risk for major fetal anomalies (adjusted odds ratio: 0.59, 95% confidence interval: 0.52–0.66). The subgroup analysis demonstrated similar results for women ≥ 40 years of age.
Conclusion AMA is associated with an overall decreased risk for major anomalies. These findings may suggest that the “all or nothing” phenomenon plays a more robust role in embryonic development with advancing oocyte age, with anatomically normal fetuses being more likely to survive.
This article was presented, in part, as an oral presentation at the 34th Annual Meeting of the Society for Maternal-Fetal Medicine; February 6, 2014; New Orleans, LA.
- 1 Martin JA, Hamilton BE, Osterman MJK, Curtin SC, Matthews TJ. Births: final data for 2012. Natl Vital Stat Rep 2013; 62 (9) 1-68
- 2 Cleary-Goldman J, Malone FD, Vidaver J , et al; FASTER Consortium. Impact of maternal age on obstetric outcome. Obstet Gynecol 2005; 105 (5 Pt 1): 983-990
- 3 Laopaiboon M, Lumbiganon P, Intarut N , et al; WHO Multicountry Survey on Maternal Newborn Health Research Network. Advanced maternal age and pregnancy outcomes: a multicountry assessment. BJOG 2014; 121 (Suppl. 01) 49-56
- 4 Salem Yaniv S, Levy A, Wiznitzer A, Holcberg G, Mazor M, Sheiner E. A significant linear association exists between advanced maternal age and adverse perinatal outcome. Arch Gynecol Obstet 2011; 283 (4) 755-759
- 5 Jacobsson B, Ladfors L, Milsom I. Advanced maternal age and adverse perinatal outcome. Obstet Gynecol 2004; 104 (4) 727-733
- 6 Stillbirth Collaborative Research Network Writing Group. Association between stillbirth and risk factors known at pregnancy confirmation. JAMA 2011; 306 (22) 2469-2479
- 7 Hollier LM, Leveno KJ, Kelly MA, MCIntire DD, Cunningham FG. Maternal age and malformations in singleton births. Obstet Gynecol 2000; 96 (5 Pt 1): 701-706
- 8 Baird PA, Sadovnick AD, Yee IM. Maternal age and birth defects: a population study. Lancet 1991; 337 (8740) 527-530
- 9 Materna-Kiryluk A, Wiśniewska K, Badura-Stronka M , et al. Parental age as a risk factor for isolated congenital malformations in a Polish population. Paediatr Perinat Epidemiol 2009; 23 (1) 29-40
- 10 Reefhuis J, Honein MA. Maternal age and non-chromosomal birth defects, Atlanta—1968-2000: teenager or thirty-something, who is at risk?. Birth Defects Res A Clin Mol Teratol 2004; 70 (9) 572-579
- 11 Bille C, Skytthe A, Vach W , et al. Parent's age and the risk of oral clefts. Epidemiology 2005; 16 (3) 311-316
- 12 Gill SK, Broussard C, Devine O, Green RF, Rasmussen SA, Reefhuis J ; National Birth Defects Prevention Study. Association between maternal age and birth defects of unknown etiology: United States, 1997-2007. Birth Defects Res A Clin Mol Teratol 2012; 94 (12) 1010-1018 (Part A)
- 13 Csermely G, Czeizel AE, Veszprémi B. Distribution of maternal age and birth order groups in cases with unclassified multiple congenital abnormalities according to the number of component abnormalities: a national population-based case-control study. Birth Defects Res A Clin Mol Teratol 2015; 103 (2) 67-75
- 14 Csermely G, Susánszky E, Czeizel AE. Association of young and advanced age of pregnant women with the risk of isolated congenital abnormalities in Hungary – a population-based case-matched control study. J Matern Fetal Neonatal Med 2015; 28 (4) 436-442
- 15 ACOG Committee on Practice Bulletins. ACOG Practice Bulletin No. 77: screening for fetal chromosomal abnormalities. Obstet Gynecol 2007; 109 (1) 217-227
- 16 Callen PW. Ultrasonography in Obstetrics and Gynecology. Philadelphia, PA: Saunders Elsevier; 2008
- 17 Pradat P. Epidemiology of major congenital heart defects in Sweden, 1981–1986. J Epidemiol Community Health 1992; 46 (3) 211-215