Advanced maternal age and perinatal outcomes in two tertiary care maternity hospitals in Colombo, Sri Lanka

Introduction: Advanced maternal age (AMA) is associated with adverse outcomes. Therefore, it is crucial to identify the maternal and perinatal outcomes among women with AMA.

Objectives: To describe the obstetric and perinatal outcomes of women with AMA, compare them with women in the 20-34-year age group and determine the adverse outcomes associated with AMA.

Method: A prospective cohort study was conducted from 1st March to 31st July 2018 at the Castle Street Hospital for Women and the De Soysa Hospital for Women, Colombo, Sri Lanka. Pregnant women >20 years old, with a gestation of >22 weeks, admitted for delivery were included. Sample size was calculated as 648. Mother-baby pairs were followed up till 7-days-of-age. Data were collected via an interviewer-administered questionnaire. Sociodemographic factors, maternal and perinatal outcomes were compared between AMA and 20–34-year age groups. Chi-square test, bivariate and multivariable logistic regression were used to determine the association of maternal and perinatal outcomes with AMA using SPSS version 23.

Results:A total of 648, with 326 AMA and 322 who were 20-34 years old were included. Mean ages were 37 ± 1.9 years and 28 ± 3.6 years in the AMA and 20-34 years age groups respectively. Comparatively, women in AMA had a higher income (AOR=0.47, 95% CI 0.305-0.747, p=0.001), higher risk of postponement of the current pregnancy (AOR=0.176, 95% CI 0.08–0.38, p=0.000), higher risk of subfertility (AOR=0.25, 95% CI 0.14–0.47, p=0.000), higher risk of undergoing a caesarean delivery (AOR=1.58, 95% CI 1.1–2.3, p=0.016), and higher risk of pre-term delivery (AOR=1.6, 95% CI 1.0-2.6, P=0.49) after adjusting for confounders.

Conclusions: AMA was associated with adverse obstetric and perinatal outcomes compared to women in the 20-34-year age group.

Sri Lanka Journal of Child Health, 2022; 51(2): 241-248