International Journal of Infertility & Fetal Medicine

Register      Login

VOLUME 14 , ISSUE 2 ( May-August, 2023 ) > List of Articles


Evaluation of Fetomaternal Outcome in Advanced Age-group Mothers: A Comparative Prospective Study in a Tertiary Care Maternity Hospital in Kashmir Valley

Shumila Manzoor, Syed M Rizvi

Keywords : Advanced age, Adverse, Fetomaternal, Pregnancy, Risks

Citation Information : Manzoor S, Rizvi SM. Evaluation of Fetomaternal Outcome in Advanced Age-group Mothers: A Comparative Prospective Study in a Tertiary Care Maternity Hospital in Kashmir Valley. Int J Infertil Fetal Med 2023; 14 (2):94-99.

DOI: 10.5005/jp-journals-10016-1316

License: CC BY-NC 4.0

Published Online: 12-05-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Aim: The study was aimed to investigate the effect of maternal age on fetomaternal outcomes in primigravida singleton women aged above 35 years vs the younger age-group of 22–35 years. Materials and methods: The study was carried out for a period of 18 months in the Department of Obstetrics and Gynaecology, Government Medical College, Srinagar, Jammu and Kashmir, India. The data were prospectively collected on 209 primigravida singleton pregnant women admitted to the hospital and were divided into two groups, one above 35 years and the other between 22 and 35 years. The fetomaternal outcome of each pregnancy was recorded and exported on the data editor of Statistical Package for the Social Sciences (SPSS) version 20.0. The comparative analysis between the two groups was done using the Student's independent t-test or Mann–Whitney U test. Results: Comparative analysis between two groups of primigravida singleton pregnant women showed that advanced-age pregnancy was significantly associated with increased incidence of gestational hypertension (38.6 vs 22.4%, p = 0.018), antepartum hemorrhage (APH) (21.1 vs 9.9, p = 0.031), spontaneous abortions (17.5 vs 7.2%, p = 0.027%), and cesarean delivery rate (64.3 vs 46.3, p = 0.042) as compared to younger age-group. Advanced-age pregnancy was associated with adverse fetal outcomes like low birth weight (26.2 vs 13.2%, p = 0.047), preterm delivery (38.1 vs 22.1%, p = 0.029), intrauterine fetal demise (IUFD) (16.7 vs 6.6%, p = 0.047), and intrauterine growth retardation (IUGR) (33.3 vs 16.21%, p = 0.016) as compared with younger age-group. Conclusion: This study shows a strong association of advanced maternal age with adverse fetomaternal outcomes, and the rising trend of delaying pregnancy makes it imperative to educate women about the risks of advanced-age pregnancy and the need for specialized care during the antenatal period.

PDF Share
  1. Heffner LJ. Advanced maternal age–how old is too old? N Engl J Med 2004,351(19): 1927–1927. DOI: 10.1056/NEJMp048087
  2. Lipipuspa P, Asima D, Avasthi S. Advanced maternal age & adverse feto-maternal outcome: a retrospective study. Int J Sci Res 2017;6(9):1475–1478.
  3. Laopaiboon M, Lumbiganon P, Intarut N, et al. Advanced maternal age and pregnancy outcomes: a multicountry assessment. BJOG 2014;121(Suppl 1):49–56. DOI: 10.1111/1471-0528.12659
  4. Blomberg M, Tyrberg RB, Kjølhede P. Impact of maternal age on obstetric and neonatal outcome with emphasis on primiparous adolescents and older women: a Swedish Medical Birth Register Study. BMJ 2014;4:e005840. DOI: 10.1136/bmjopen-2014-005840
  5. Annual Vital statistics Part 4.orebro, Sweden; Statistics Sweden2002.
  6. Jacobsson B, Ladfors L, Milsom I. Advanced maternal age and adverse perinatal outcome Obstet Gynecol 2004;104(4):727–733. DOI: 10.1097/
  7. Wang Y, Tanbo T, Abyholm T, et al. The impact of advanced maternal age and parity on obstetric and perinatal outcomes in singleton gestations. Arch Gynecol Obstet 2011;284(1):31–37. DOI: 10.1007/s00404-010-1587-x
  8. Kenny LC, Lavender T, McNamee R, et al. Advanced maternal age and adverse pregnancy outcome: evidence from a large contemporary cohort. PloS One 2013;8(2):e56583. DOI: 10.1371/journal.pone.0056583
  9. Martin JA, Hamilton BE, Ventura SJ, et al. Births: final data for 2010. Natl vital stat Rep 2012;61(1):1–17.
  10. Kahveci B, Melekoglu R, Evruke IC, et al. The effect of advanced maternal age on perinatal outcomes in nulliparous singleton pregnancies. BMC Pregnancy Childbirth 2018;18(1):343. DOI: 10.1186/s12884-018-1984-x
  11. Waldenstrom U, Cnattingius S, Norman M, et al. Advanced maternal age and stillbirth risk in nulliparous and parous women. Obstet Gynecol 126(2):355–362. DOI: 10.1097/AOG.0000000000000947
  12. Geller SE, Cox SM, Callaghan WM, et al. Morbidity and mortality in pregnancy: laying the groundwork for safe motherhood. Womens Health Issues 2006;16(4):176–188. DOI: 10.1016/j.whi.2006.06.003
  13. Creanga AA, Syverson C, Seed K, et al. Pregnancy-Related Mortality in the United States, 2011-2013. Obstet Gynecol 2015;125(2):5. DOI: 10.1097/AOG.0000000000002114
  14. Hansen JP. Older maternal age and pregnancy outcome: a review of the literature. Obstet Gynecol Surv 1986;41(11): 726–742. DOI: 10.1097/00006254-198611000-00024
  15. Azharuddin; Perils of ‘LatemarriageinKashmir;; guestcolumn; June22,2020
  16. Wasim Rasool; Late Marriages;Who is Responsible; Greater Kashmir February12th
  17. Dar MA. Youth transition to employment and marriage in Kashmir: changing perceptions and attitudes. Int J Curr Adv Res 2018;3(2):1797–1803.
  18. Rehman BU, Sirwal RK, Wani FA, et al. A comparative prospective study of maternofetal outcome in advanced and younger maternal age-group in higher socioeconomic strata. Int J Reprod Contracept Obstet Gynecol 2017;6(4):1362–1367. DOI: 10.18203/2320-1770.ijrcog20171392
  19. Aamir Ahmad Teeli. J&K falling fertility rate;Greater Kashmir e-paper;Nov10,2021.
  20. National Family Health Survey-5; Fact sheet; Ministry of Health and Family Welfare.
  21. Rendtorff R, Hinkson L, Kiver V, et al. Pregnancies in women aged 45 years and older - a 10-year retrospective analysis in Berlin. Geburtshilfe Frauenheilkd 2017;77(3):268–275. DOI: 10.1055/s-0043-100105
  22. Nagarwal K, Chandrakanta, Gaur K, et al. Pregnancy outcome comparison in elderly and non elderly primigravida attending at Mahila Chikitsalay, Jaipur (Rajasthan) India. Int J Multispeciality Health 2015;1(1).
  23. Mehari MA, Maeruf H, Robles CC, et al. Advanced maternal age pregnancy and its adverse obstetrical and perinatal outcomes in Ayder comprehensive specialized hospital, Northern Ethiopia, 2017: a comparative cross-sectional study. BMC Pregnancy Childbirth 2020;20(1):60. DOI: 10.1186/s12884-020-2740-6
  24. Suneela MS. Effect of advanced maternal age on pregnancy outcome - a retrospective cohort study. Indian J Obstet Gynecol Res 2021;8(3):377–382.
  25. Dibaba B, Edosa D, Hajure M, et al. Risk factors of antepartum hemorrhage among mothers who gave birth at Suhul General Hospital, 2016: a case-control study. J Multidiscip Healthc 2021;14:271–278. DOI: 10.2147/JMDH.S269744.
  26. Yılmaz E, Tosun ÖA, Tarhan N, et al. Perinatal outcomes in advanced age pregnancies. J Clin Exp Investig 2016;7(2):157–162. DOI: 10.5799/ahinjs.01.2016.02.0589
  27. American College of and Gynecologists. Female age-related fertility decline. Committee Obstetricians Opinion 589. Fertil Steril 2014;101(3):633–634.
  28. Magnus MC, Wilcox AJ, Morken NH, et al. Role of maternal age and pregnancy history in risk of miscarriage: prospective register based study. BMJ 2019;364:l869. DOI: 10.1136/bmj.l869
  29. Almeida ND, Basso O, Abrahamowicz M, et al. Risk of miscarriage in women receiving antidepressants in early pregnancy, correcting for induced abortions. Epidemiology 2016;27(4):538–546. DOI: 10.1097/EDE.0000000000000484
  30. Agenor A, Bhattacharya S. Infertility and miscarriage: common pathways in manifestation and management. Womens Health 2015:11(4):527–541. DOI: 10.2217/WHE.15.19
  31. Nybo Andersen AM, Wohlfahrt J, Christens P, et al. Maternal age and fetal loss: population based register linkage study. BMJ 2000;320(7251):1708–1712. DOI: 10.1136/bmj.320
  32. Luke B, Brown MB. Elevated risks of pregnancy complications and adverse outcomes with increasing maternal age. Hum Reprod 2007;22:1264–1272. DOI: 10.1093/humrep/del522
  33. Greenberg MB, Cheng YW, Sullivan M. Does length of labor vary by maternal age? Am J Obstet Gynecol 2007;197(4):428.e1-7. DOI: 10.1016/j.ajog.2007.06.058
  34. Elmes M, Szyszka A, Pauliat C. Maternal age effects on myometrial expression of contractile proteins, uterine gene expression, and contractile activity during labor in the rat. Physiol Rep 2015;3(4):e12305. DOI: 10.14814/phy2.12305
  35. Ganie MA, Rashid A, Sahu D, et al. Prevalence of polycystic ovary syndrome (PCOS) among reproductive age women from Kashmir valley: A cross-sectional study. Int J Gynecol Obstet 2020;149(2):231–236. DOI: 10.1002/ijgo.13125
  36. Maheshwari A, Porter M, Shetty A, et al. Women's awareness and perceptions of delay in childbearing. Fertil Steril 2008;90(4):1036–1042. DOI: 10.1016/j.fertnstert.2007.07.1338
  37. Nicole P, Edgar M. Female age and assisted reproductive technology. Glob Reprod Health 2018;3(2):e9. DOI: 10.1097/GRH.0000000000000009
  38. Mills G, Badeghiesh A, Suarthana E, et al. Polycystic ovary syndrome as an independent risk factor for gestational diabetes and hypertensive disorders of pregnancy: a population-based study on 9.1 million pregnancies. Hum Reprod 2020;35(7):1666–1674. DOI: 10.1093/humrep/deaa099
  39. Li X, Liu X, Zuo Y, et al. The risk factors of gestational diabetes mellitus in patients with polycystic ovary syndrome: what should we care. Medicine (Baltimore) 2021;100(31):e26521. DOI: 10.1097/MD.0000000000026521
  40. Dietl A, Cupisti S, Beckmann MW. Pregnancy and obstetrical outcomes in women over 40 years of age. Geburtshilfe Frauenheilkd 2015;75:827–832. DOI: 10.1055/s-0035-1546109
  41. Pasupathy D, Wood AM, Pell JP, et al. Advanced maternal age and the risk of perinatal death due to intrapartum anoxia at term. J Epidemiol Community Health 2011;65(3):241–245. DOI: 10.1136/jech.2009.097170
  42. Mahato V, Shrestha P, Bhattarai P. Advanced maternal age and pregnancy outcome at Manipal Teaching Hospital: cross-sectional analytical study. Nepal J Med Sci 2021;6(1):20–25. DOI: 10.3126/njms.v6i1.36728
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.