Download PDF
Am J Perinatol 2023; 40(06): 619-623
DOI: 10.1055/s-0041-1730350
Original Article

Neonatal Outcome of Babies Born to Women 40 Years and Older in a Jamaican Birth Cohort

Helen Trotman 
1   Department of Child and Adolescent Health, Faculty of Medical Sciences, University of the West Indies, Mona, St. Andrew, Jamaica
,
Maureen Samms-Vaughan
1   Department of Child and Adolescent Health, Faculty of Medical Sciences, University of the West Indies, Mona, St. Andrew, Jamaica
,
Charlene Coore-Desai
1   Department of Child and Adolescent Health, Faculty of Medical Sciences, University of the West Indies, Mona, St. Andrew, Jamaica
,
Jody-Ann Reece
1   Department of Child and Adolescent Health, Faculty of Medical Sciences, University of the West Indies, Mona, St. Andrew, Jamaica
,
Oluwayomi Olugbuyi
1   Department of Child and Adolescent Health, Faculty of Medical Sciences, University of the West Indies, Mona, St. Andrew, Jamaica
› Author Affiliations Funding The Inter-American Development Bank (grant reference: ATN/JF-12312-JA and ATN/OC-14535-JA) and the University of the West Indies, Mona Campus provided core support for JA KIDS. Additional support was provided by the World Bank, UNICEF, the CHASE Fund, the National Health Fund, Parenting Partners Caribbean, the University of Nevada - Las Vegas, the University of Texas Health Science Centre at Houston, and Michigan State University and its Partners. This publication is the work of the authors Helen Trotman, Maureen Samms Vaughan, Charlene Coore-Desai, Jody Reece and Oluwayomi Olugbuyi who will serve as guarantors for the contents of this paper.
› Further Information
    Permissions and Reprints

Abstract

Objective The study aimed to determine the outcome of babies born to women ≥40 years in a Jamaican birth cohort.

Study Design Maternal demographic data and neonatal data for women ≥40 years who delivered live singleton babies and their younger counterparts aged 20 30 years were extracted from the JA KIDS birth cohort dataset. Outcome measures were preterm birth, low birth weight, very low birth weight, extremely low birth weight, macrosomia, a low 5-minute Apgar score <7, admission to the neonatal unit, and neonatal death. Descriptive analyses were performed; statistical significance was taken at the level p <0.05.

Results A total of 5,424 women and their babies were entered into the study, 5,099 (94%) women were aged 20 to 30 years (mean age ± standard deviation [SD]: 24.5 ± 3.2 years) and 325 (6%) were aged ≥40 years (mean age ± SD: 41.5 ± 1.6 years). A greater percentage of preterm babies (18%) were born to women ≥40 years than to their younger counterparts (14%; p = 0.04). There was no difference in the proportion of low birth weight infants, very low birth weight infants, or extremely low birth weight infants born between the two groups (p > 0.05). There was also no significant difference in the proportion of babies who were macrosomic and in those who had a low 5-minute Apgar score <7. There were 866 (16%) neonatal admissions, 67/325 (21%) of these babies were born to women aged ≥40 years and 799/5,099 (16%) were born to their younger counterparts (p = 0.01). The commonest reason for admission was prematurity. While 60 babies died, there was no significant difference between both groups with 56 (1%) born to women 20 to 30 years and 4 (1%) born to women ≥40 years (p = 0.48).

Conclusion Adverse outcomes noted for babies born to women ≥40 years were prematurity and the need for neonatal admission. However, no excess mortality was recorded.

Key Points

  • Women 40 years and older are more likely to have a chronic illness such as hypertension and diabetes and to have an operative delivery.

  • Babies born to women 40 years and older are more likely to be late premature infants and require neonatal admission.

  • However, there is no increased risk of neonatal mortality.

Keywords

advanced maternal age - neonatal outcome - low and middle income countries


Publication History

Received: 26 February 2020

Accepted: 09 April 2021

Article published online:
27 May 2021

© 2021. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Bianco A, Stone J, Lynch L, Lapinski R, Berkowitz G, Berkowitz RL. Pregnancy outcome at age 40 and older. Obstet Gynecol 1996; 87 (06) 917-922
    CrossrefPubMedGoogle Scholar
  • 2 Wang Y, Tanbo T, Abyholm T, Henriksen T. The impact of advanced maternal age and parity on obstetrics. Arch Gynecol Obstet 2011; 284 (01) 31-37
    CrossrefPubMedGoogle Scholar
  • 3 Johnson-Harrison TA, Trotman H. Neonatal outcome of babies born to women 40 years and over at the university hospital of the West Indies 2012-2013. J Trop Pediatr 2018; 64 (03) 225-230
    CrossrefPubMedGoogle Scholar
  • 4 Canto MJ, Reus A, Cortés S, Ojeda F. Pregnancy outcome in a Spanish population of women beyond age 40 delivered above 32 weeks' gestation. J Matern Fetal Neonatal Med 2012; 25 (05) 461-466
    CrossrefPubMedGoogle Scholar
  • 5 Berkowitz GS, Skovron ML, Lapinski RH, Berkowitz RL. Delayed childbearing and the outcome of pregnancy. N Engl J Med 1990; 322 (10) 659-664
    CrossrefPubMedGoogle Scholar
  • 6 Delpisheh A, Brabin L, Attia E, Brabin BJ. Pregnancy late in life: a hospital-based study of birth outcomes. J Womens Health (Larchmt) 2008; 17 (06) 965-970
    CrossrefPubMedGoogle Scholar
  • 7 Kenny LC, Lavender T, McNamee R, O'Neill SM, Mills T, Khashan AS. Advanced maternal age and adverse pregnancy outcome: evidence from a large contemporary cohort. PLoS One 2013; 8 (02) e56583
    CrossrefPubMedGoogle Scholar
  • 8 Hoque ME. Advanced maternal age and outcomes of pregnancy: a retrospective study from South Africa. Biomed Res 2012; 23 (02) 281-285
    PubMedGoogle Scholar
  • 9 Ludford I, Scheil W, Tucker G, Grivell R. Pregnancy outcomes for nulliparous women of advanced maternal age in South Australia, 1998-2008. Aust N Z J Obstet Gynaecol 2012; 52 (03) 235-241
    CrossrefPubMedGoogle Scholar
  • 10 Alberto VE, Marta LC, Omacrosomia GA, Raul CA. Obstetric outcomes at advanced maternal age. J Gynaecol Obstet 2014; 2 (01) 7-11
    PubMedGoogle Scholar
  • 11 Joseph KS, Allen AC, Dodds L, Turner LA, Scott H, Liston R. The perinatal effects of delayed childbearing. Obstet Gynecol 2005; 105 (06) 1410-1418
    CrossrefPubMedGoogle Scholar
  • 12 Ates S, Batmaz G, Sevket O, Molla T, Dane C, Dane B. Pregnancy outcome of multiparous women aged over 40 years. Int J Reprod Med 2013; 2013: 287519
    CrossrefPubMedGoogle Scholar
  • 13 Başer E, Seçkin KD, Erkılınç S. et al. The impact of parity on perinatal outcomes in pregnancies complicated by advanced maternal age. J Turk Ger Gynecol Assoc 2013; 14 (04) 205-209
    CrossrefPubMedGoogle Scholar
  • 14 Andriantoky VB, Johannes RF, Vololonarivelo BE, Rakotovao AH. Late pregnancies outcomes: assessment of the obstetrical risks at the university hospital of the gynaecology and obstetrics, Befelatanana, Madagascar. Int J Reprod Contracept Obstet Gynecol 2014; 3 (02) 310-316
    CrossrefPubMedGoogle Scholar
  • 15 Lisonkova S, Janssen PA, Sheps SB, Lee SK, Dahlgren L. The effect of maternal age on adverse birth outcomes: does parity matter?. J Obstet Gynaecol Can 2010; 32 (06) 541-548
    CrossrefPubMedGoogle Scholar
  • 16 Ngowa JDK, Ngassam AN, Dohbit JS, Nzedjom C, Kasia JM. Pregnancy outcome at advanced maternal age in a group of African women in two teaching Hospitals in Yaounde, Cameroon. Pan Afr Med J 2013; 14: 134
    PubMedGoogle Scholar
  • 17 Shaikh F, Wagan F, Jillani K, Memon K. Pregnancy outcome at maternal age 40 and older. JLUMHS 2012; 11 (03) 139
    PubMedGoogle Scholar
  • 18 Cakmak Celik F, Aygun C, Kucukoduk S, Bek Y. Maternal and neonatal outcomes in advanced maternal age: a retrospective cohort study. J Matern Fetal Neonatal Med 2017; 30 (20) 2452-2456
    CrossrefPubMedGoogle Scholar
  • 19 Jahromi BN, Husseini Z. Pregnancy outcome at maternal age 40 and older. Taiwan J Obstet Gynecol 2008; 47 (03) 318-321
    CrossrefPubMedGoogle Scholar