The effect of advanced maternal age on pregnancy outcome in women with cervical insufficiency treated with cerclage

The effect of advanced maternal age on pregnancy outcome

Authors

  • Mohamed Alkhatim Alsammani
  • Muneera A Alsheeha
  • Salah R Ahmed
  • Abdelmagid Mustafa Abdalla

DOI:

https://doi.org/10.70284/njirm.v3i3.2040

Keywords:

age, maternal, cerclage, cervical, pregnancy outcomes

Abstract

Background: As a woman’s age increases, infertility also increases. Women with cervical insufficiency seek pregnancy at advanced age. Objectives: This study quantifies pregnancy outcome in women with cervical incompetence according to maternal age. Methods: A register-based study conducted between May 1, 2010 to April 30, 2011 at MCH, Qassim, KSA. During this period, 8723 deliveries and 52 cases with cervical insufficiency were identified. Patients were divided according to maternal age into group 1 less than 35 years of age or group 2 at or greater than 35 years of age. Results: Out of these 52, 38(73.1%) comprised Group1 and 14 (26.9%) comprised group 2. Patients in group 2, were older, (40 vs. 27 years, P=0.00), of high gravidity (17 vs. 4, P=0.00), had less previous history of ERCP (14.3% vs.31.6% P=0.002), were likely delivered by caesarean section (0.002) and were less likely developed PROM (P=0.047). However, both groups (G1 and G2) were similar in gestational age at delivery (36.6 vs. 36.6 weeks, P=0.95), the abortion rate, [8(21.1%) vs. 2(14.3%), P=0.58], and the rate of preterm delivery, 3(10.3%) vs. 2(16.7%) respectively (P=0.57). Conclusion: pregnancy outcome in women with cervical incompetence and advanced maternal age is not influenced by maternal age.

References

1. Kane SH. Advancing age and the primigravida. Obstet Gynecol. 1967;29(3):409-14.
2. Hook EB. Maternal age, reproduction and chromosomal aberrations in Wistar derived rats. Obstet Gynecol. 1981;58(3):282-5.
3. Ventura SJ. Trends and variations in first births to older women, United States, 1970-86. Vital Health Stat 21. 1989;(47):1-27.
4. Spellacy WN, Handler A and Ferre CD. A case-control study of 1253 twin pregnancies from a 1982-1987 perinatal data base. Obstet Gynecol. 1990 ;75(2):168-71.
5. Gilbert WM, Nesbitt TS and Danielsen B. Childbearing beyond age 40: pregnancy outcome in 24,032 cases. Obstet Gynecol. 1999;93(1):9-14.6. Lidegaard O. Cervical incompetence and cerclage in Denmark 1980–1990. A register-based epidemiological survey. Acta Obstet Gynecol Scand. 1994;73:35–8.
7. Nybo Andersen AM, Wohlfahrt J, Christens P, Olsen J, Melbye M. Maternal age and fetal loss: population based register linkage study. BMJ. 2000;320(7251):1708-12.
8. Osborn JF, Cattaruzza MS, Spinelli A. Risk of spontaneous abortion in Italy, 1978-1995, and the effect of maternal age, gravidity, marital status, and education. Am J Epidemiol. 2000;151(1):98-105.
9. Devroey P, Godoy H, Smitz J, Camus M, Tournaye H, Derde MP et al. Female age predicts embryonic implantation after ICSI: a case-controlled study. Hum Reprod. 1996;11(6):1324-7
10. Narayan H, Buckett W, McDougall W, Cullimore J. Pregnancy after fifty: profile and pregnancy outcome in a series of elderly multigravidae. Eur J Obstet Gynecol Reprod Biol. 1992;47(1):47-51.
11. Kirz DS, Dorchester W, Freeman RK. Advanced maternal age: the mature gravida. Am J Obstet Gynecol. 1985;152(1):7-12.
12. Wang Y, Tanbo T, Abyholm T, Henriksen T. The impact of advanced maternal age and parity on obstetric and perinatal outcomes in singleton gestations. Arch Gynecol Obstet. 2011;284(1):31-7.
13. Chryssikopoulos A, Botsis D, Vitoratos N, Loghis C. Cervical incompetence: a 24-year review. Int J Gynaecol Obstet. 1988;26(2):245-53.
14. Edge V, Laros RK Jr. Pregnancy outcome in nulliparous women aged 35 or older. Am J Obstet Gynecol. 1993;168(6 Pt 1):1881-4; discussion 1884-5.
15. Prysak M, Lorenz RP, Kisly A. Pregnancy outcome in nulliparous women 35 years and older. Obstet Gynecol. 1995;85(1):65-70.
16. Ojule JD, Ibe VC, Fiebai PO. Pregnancy outcome in elderly primigravidae. Ann Afr Med. 2011;10(3):204-8.
17. Kanungo J, James A, McMillan D, Lodha A, Faucher D, Lee SK et al. Advanced maternal age and the outcomes of preterm neonates: a social paradox? Obstet Gynecol. 2011;118(4):872-7
18. O'Dwyer V, Hogan JL, Farah N, Kennelly MM, Fitzpatrick C, Turner MJ. Maternal mortality and
the rising cesarean rate. Int J Gynaecol Obstet. 2012;116(2):162 4. Epub 2011 Nov 26.
19. Bianco A, Stone J, Lynch L, Lapinski R, Berkowitz G, Berkowitz RL. Pregnancy outcome at age 40 and older. Obstet Gynecol. 1996;87(6):917-22.
20. Irwin DE, Savitz DA, Bowes WA Jr, St André KA. Race, age, and cesarean delivery in a military population. Obstet Gynecol. 1996;88(4 Pt 1):530-3.
21. Milner M, Barry-Kinsella C, Unwin A, Harrison RF. The impact of maternal age on pregnancy and its outcome. Int J Gynaecol Obstet. 1992;38(4):281-6.
22. Ezra Y, McParland P, Farine D. High delivery intervention rates in nulliparous women over age 35. Eur J Obstet Gynecol Reprod Biol. 1995;62(2):203-7.
23. Berghella V, Keeler SM, To MS, Althuisius SM, Rust OA. Effectiveness of cerclage according to severity of cervical length shortening: a meta-analysis. Ultrasound Obstet Gynecol. 2010;35(4):468-73.
24. Final report of the Medical Research Council/Royal College of Obstetricians and Gynaecologists multicentre randomised trial of cervical cerclage. MRC/RCOG Working Party on Cervical Cerclage. et al. Br J Obstet Gynaecol. 1993; ;100(6):516-23.
25. Harger JH, Archer DF, Marchese SG, Muracca-Clemens M, Garver KL. Etiology of recurrent pregnancy losses and outcome of subsequent pregnancies. Obstet Gynecol. 1983;62(5):574-81.

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Published

2012-08-31

How to Cite

Alsammani, M. A., Alsheeha, M. A., Ahmed, S. R., & Abdalla, A. M. (2012). The effect of advanced maternal age on pregnancy outcome in women with cervical insufficiency treated with cerclage: The effect of advanced maternal age on pregnancy outcome. National Journal of Integrated Research in Medicine, 3(3), 63–67. https://doi.org/10.70284/njirm.v3i3.2040

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