Contribution of Maternal Age, Medical, and Obstetric History to Maternal and Perinatal Morbidity/Mortality for Women Aged 35 or Older

(Aust N Z J Obstet Gynaecol. 2018;58:91–97) Pregnancy at advanced maternal age (defined as 35 y or greater at the time of birth) is becoming more common due to advanced fertility and contraceptive techniques and changing sociocultural trends. Pregnancy complications have been reported to occur at a higher rate in these women, including fetal chromosomal abnormalities, gestational diabetes, and hypertensive disorders of pregnancy. It is established that chromosomal abnormalities are directly related to maternal age. The other complications, however, have also generally been attributed to advanced maternal age with limited consideration given to whether the women’s medical history and previous pregnancies might contribute to the increased risk of these complications. The goal of this study was to determine the frequency of severe maternal and perinatal morbidity and mortality in women of advanced maternal age, on the basis of preexisting medical conditions and prior pregnancy complications, and to assess whether maternal age independently affected the risk of adverse pregnancy outcomes.