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Inonu University, Turgut Ozal Medical Centre

The effect of advanced maternal age on perinatal outcomes in nulliparous singleton pregnancies. Bekir Kahveci Rauf Melekoglu Ismail Cuneyt Evruke Cihan Cetin. Inonu University, Turgut Ozal Medical Centre. Advanced Maternal Age and Pregnancy Outcomes.

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Inonu University, Turgut Ozal Medical Centre

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  1. The effect of advanced maternal age on perinatal outcomes in nulliparous singleton pregnancies BekirKahveci Rauf Melekoglu Ismail CuneytEvruke Cihan Cetin Inonu University, Turgut Ozal Medical Centre

  2. Advanced Maternal Age and Pregnancy Outcomes • Advanced maternal age is defined as being 35 years or older at delivery, very advanced maternal age is used to describe women older than 40 or 45 years. • Pregnancies at the advanced maternal age have been gradually rising in both developed and developing countries over the last decades. • Widespread use of family planning, deferring pregnancy for the industrial or academic career plan and advances in assisted reproductive techniques contribute this increment

  3. Advanced Maternal Age and Pregnancy Outcomes • The association between adverse perinatal outcomes and advanced maternal age has controversially discussed in several studies. • While several studies have noted an increased rate of adverse pregnancy outcomes in women older than 35 years, others have failed to find any association between advanced maternal age and adverse perinatal outcomes

  4. Advanced Maternal Age and Pregnancy Outcomes Objective To determine the impact of advanced maternal age on perinatal and neonatal outcomes of nulliparous singleton pregnants. Material and Methods 471 pregnant aged 18-34 Demographic characteristics and perinatal outcomes Admitted for the routine mid-trimester fetal ultrasound scan A total of 957 singleton pregnancies 399 pregnant aged between 35-39 87 pregnant aged 40 or more

  5. Advanced Maternal Age and Pregnancy Outcomes • Inclusion criteria • Maternal age between 18-45; • Singleton viable pregnancy; • Nulliparity; • Admission at 18-23 weeks of gestation for mid-trimester fetal ultrasound scan; • Unremarkable obstetric history • Exclusion criteria • Any concomitant chronic disease (diabetes, hypertension, chronic renal disease); • Body mass index >35 kg/m2; • A history of IUI and IVF/ICSI); • A history of uterine surgery; • Any known Mullerian anomaly; • Multiple pregnancies; • Any fatal congenital anomalies or chromosomal abnormalities

  6. Advanced Maternal Age and Pregnancy Outcomes Results Control Group AdvancedAge Very Advanced Age (18≤ - ≤ 35) (35 - <40) (≥40) n=471 n=399 n=87 Age27.6 ±4.2a 36.6±1.4b 41.71±2.0c BMI 28.7 ±4.1a29.9 ±5.8a30.1±4.6a Consanguinity26(5.5)a 19 (4.7)a 3 (3.4)a CVS & AS 24 (5.1)a 26 (6.5)a 23 (26.4)b Education P school 12 (2.5) a 19 (4.7) a 6 (6.9)a H school 81 (17.2)a 76 (19.1) a 17 (19.6)a Graduated 378 (80.3) a 304 (76.2)a 77 (88.5)a

  7. Advanced Maternal Age and Pregnancy Outcomes

  8. Advanced Maternal Age and Pregnancy Outcomes

  9. Advanced Maternal Age and Pregnancy Outcomes

  10. Advanced Maternal Age and Pregnancy Outcomes • Conclusion • Thisstudy demonstrated that advanced maternal age is a risk factor for gestational diabetes, gestational hypertension, pre-eclampsia, SGA, spontaneous late preterm delivery between 34 and 37 weeks of gestation and cesarean section. • The interpretation of these findings to the clinical practice might have significant implications on maternal and perinatal outcomes of advanced age pregnants. • The modification of follow-up protocols according to these increasing obstetric risk factors could improve pregnancy outcomes of this patient group. Thank you

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