To compare pregnancy outcomes and rates of complications in women without gestational diabetes stratified by maternal age.METHODS:
We designed a retrospective cohort analysis using data compiled from singleton, non-anomalous gestations in the United States. Using multivariate regression and χ2 tests, we examined maternal and neonatal outcomes stratified by maternal age at time of delivery. Women ages 20–25 severed as reference values. Outcomes examined included preterm delivery, birth weight >4,000 g, small for gestational age, intrauterine fetal demise, neonatal death, cesarean section, abruption, chorioamnionitis, and post-partum hemorrhage. P-value less than 0.05 was considered statistically significant.RESULTS:
In a population of 1.85 million non-anomalous singleton deliveries, 1,718,481 women without gestational diabetes were identified. Women ≤20 year old had higher rates of preterm deliveries <32 w (OR 1.28; 95% CI 1.20–1.25) compared to women ≥40 (OR 0.95; 95% CI 1.11–1.28). Women 35–40 had increased IUFD (OR 1.68; 95% CI 1.40–2.02). Women 35–40 and ≥40 had higher cesarean section (OR 1.60; 95% CI 1.59–1.62 and OR 1.29; 95% CI 1.26–1.31) and post-partum hemorrhage (OR 1.09; 95% CI 1.05–1.12 and OR 1.10; 95% CI 1.04–1.16) rates. Women ≤20 had lower rates of placental abruption rates (OR 0.98; 95% CI 0.81–0.93) and chorioamnionitis (OR 0.74; 95% CI 0.72–0.77).CONCLUSION:
Among women without gestational diabetes, younger maternal age is associated with lower risk of cesarean section, placental abruption and chorioamnionitis. Women of advanced maternal age face increased risk for SGA, IUFD, cesarean sections and post-partum hemorrhage. Women at extremes of maternal age have greater risk of preterm delivery and neonatal death.