Advanced maternal age and the risk of stillbirth at term
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PETROV, Victor, BURSACOVSCHI, Natalia, EŢCO, Constantin. Advanced maternal age and the risk of stillbirth at term. In: Perinatal medicine: XXV European Congress, 15-18 iunie 2016, Amsterdam. Amsterdam, Olanda: 2016, pp. 207-208. ISSN 1476-7058. 10.1080/14767058.2016.1191212
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Perinatal medicine 2016
Conferința "Perinatal medicine. "
Amsterdam, Țările de Jos, 15-18 iunie 2016

Advanced maternal age and the risk of stillbirth at term


Pag. 207-208

Petrov Victor1, Bursacovschi Natalia1, Eţco Constantin2
 
1 Institute of Mother and Child,
2 ”Nicolae Testemițanu” State University of Medicine and Pharmacy
 
 
Teze de doctorat:
 
Disponibil în IBN: 9 septembrie 2024


Rezumat

Introduction: Delayed child-bearing, which has increased greatly in recent decades, is associated with an increased risk of adverse pregnancy outcome [Laopaiboon M et al. 2014, Jo-Ann Johnson et al., 2012]. Thus, advanced maternal age (?35 years) has been reported as a risk factor strongly associated with stillbirth in many developing countries [Aminu M. et al., 2014]. Fretts and colleagues have shown that maternal age over 35 years is associated with increased risk of fetal death. These findings were confirmed in multiple studies, and association persists even after adjustment date for potential covariates such as genetic problems, innate defects, medical problems and maternal weight [R.M. Silver, 2007]. Materials and methods: A retrospective case-control study was handled. The sample size was limited by the total number of stillbirths at term (0 Apgar score at the first and fifth minute of life) registered in the Institute of Mother and Child (IMC) of Republic of Moldova during 2013-2014. The control group consisted of live births in the same obstetric units. As mature were considered newborns since 37 obstetric week. The study group (L1) included 39 cases of intrauterine fetal demise at term, the control group (L0) - 69 live births. In order to obtain the necessary information it has been examined the stationary patient chart (Form 000-1/e). Data collection was carried out by means of a specially developed questionnaire. Clinical cases and summary results: The stillbirth rate in the IMC was equal to 12%0 and 9,0%0 in the 2013 and 2014, respectively, compared with 7.1 and 6,2 at the national level. A considerable difference is explained by the fact that the IMC is a medical institution of III level, where, according to predetermined criteria, are focused pregnant women with the presence of risk factors, as well as those, whose pregnancy has complicated by intrauterine fetal death. In 2013 in the framework of IMC stillbirth explained 54.5% of all perinatal losses (72/132), in 2014 - 51, 3% (61/119). Stillbirth rate at term was stable during 2013-2014 years (3,3 and 3,2%, respectively). The present study revealed that the average age of women who gave birth to an intrauterine mature demised fetus is higher than in the control group (29.26 vs. 26,75 years). At the same time, the share of women with the age ?35 years is higher in the group of stillborn’s (25,64% vs.2.9%). Odds Ratio (OR) for this risk factor was equal to 11.6 (CI 2,38-56,05). Conclusion: Advanced maternal age is a significant risk factor associated with stillbirth at the gestational term of 37 weeks and over. The risk of intrauterine death of mature fetus is, at least, double times higher in the older pregnant women. Deeper research should be carried out in order to prove the influence of maternal age on the course of ante- and intrapartum period in association with the coexisting factors and medical conditions.

Cuvinte-cheie
stillbirth, maternal age