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THE ASSOCIATION BETWEEN ADVANCED MATERNAL AGE AND STILLBIRTH RISK
Amneh Fadl*, Ahmad Youssef and Thora Naissa
Background: Pregnancy at advanced maternal age (AMA) has become more common over the last decades. The association between adverse perinatal outcomes and AMA has been a matter of controversy in several studies. Objective: the aim of the study is to investigate the impact of maternal age on stillbirth risk of singleton pregnancies without fetal defects. Materials and Methods: This is prospective study conducted in the Department of Obstetrics and Gynaecology in Tishreen University Hospital –Lattakia- Syria from November 2019 to November 2020. All pregnant women who aged 20 to 49 years were included in the study. Results: A total of 1560 pregnant women were included in the study, Mean maternal age was 28.7 ± 6.2 years with 254(16.3%) women in the group of age 35-39 years and 81(5.2%) women? 40 years, stillbirths were recorded in 32(2%) cases at a rate 20.5 per 1000 delivery. Maternal age was an independent risk factor for stillbirth, compared to the reference, group age ? 40 years had a significantly higher risk of stillbirth than group of age 35-39 years (HR: 2.73;95% CI:0.64-11.7 vs HR:2.01;95% CI:0.63-6.4, P:0.04). Other risk factors of stillbirth were: Smoking (HR: 2.46; 95% CI:1.12-5.4, P:0.02), nulliparous women (HR:3.61;95% CI:1.6-8,P:0.001), pre-existing hypertension(HR: 2.87 ;95%CI:1.2-6.49,P:0.01)and pre-existing diabetes mellitus (HR: 4.6 ;95% CI:1.9-11,P:0.0005). The risk for stillbirth was higher in older nulliparous women than older multiparous. Conclusion: AMA is an independent risk factor for stillbirth. Therefore, it is better for health care providers to counsel couples who seek to have the first child at advanced age about the risks of pregnancy in this period.[Full Text Article]