Medical and obstetric complications among pregnant women aged 45 and older.
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OBJECTIVE: The number of women aged 45 and older who become pregnant is increasing. The objective of this study was to estimate the risk of medical and obstetric complications among women aged 45 and older. METHODS: The Nationwide Inpatient Sample was used to identify pregnant woman during admission for delivery. Deliveries were identified using International Classification of Diseases, Ninth Revision (ICD-9-CM) codes. Using ICD-9-CM codes, pre-existing medical conditions and medical and obstetric complications were identified in women at the time of delivery and were compared for women aged 45 years and older to women under age 35. Outcomes among women aged 35-44 were also compared to women under age 35 to determine if women in this group demonstrated intermediate risk between the older and younger groups. Logistic regression analyses were used to calculate odds ratios with 95% confidence intervals for pre-existing medical conditions and medical and obstetric complications for both older groups relative to women under 35. Multivariable logistic regression analyses were also developed for outcomes at delivery among older women, while controlling for pre-existing medical conditions, multiple gestation, and insurance status, to determine the effect of age on the studied outcomes. RESULTS: Women aged 45 and older had higher adjusted odds for death, transfusion, myocardial infarction/ischemia, cardiac arrest, acute heart failure, pulmonary embolism, deep vein thrombosis, acute renal failure, cesarean delivery, gestational diabetes, fetal demise, fetal chromosomal anomaly, and placenta previa compared to women under 35. CONCLUSION: Pregnant women aged 45 and older experience significantly more medical and obstetric complications and are more likely to die at the time of a delivery than women under age 35, though the absolute risks are low and these events are rare. Further research is needed to determine what associated factors among pregnant women aged 45 and older may contribute to these findings.
Published Version (Please cite this version)10.1371/journal.pone.0096237
Publication InfoGrotegut, Chad A; Chisholm, Christian A; Johnson, Lauren NC; Brown, Haywood L; Heine, R Phillips; & James, Andra H (2014). Medical and obstetric complications among pregnant women aged 45 and older. PLoS One, 9(4). pp. e96237. 10.1371/journal.pone.0096237. Retrieved from https://hdl.handle.net/10161/11092.
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F. Bayard Carter Distinguished Professor Emeritus of Obstetrics and Gynecology
Research focus is on health disparities as related to perinatal outcomes. Specific focus on the epidemiology of preterm delivery, infant and maternal mortality. Other research focus is on medical co-morbidities such as hypertension and cardiovascular conditions and the impact on pregnancy.
Associate Professor of Obstetrics and Gynecology
I am a specialist in maternal-fetal medicine, which is a subspecialty of OB/GYN that focuses on the care of women with high-risk pregnancies. I serve as the Medical Director of the Labor and Delivery Unit at Duke University Hospital. In that role, and together with our outstanding unit team members, we have the opportunity to help women and their families ensure that they have the safest and best labor and delivery experience possible. My specific clinical int
Professor of Obstetrics and Gynecology
Professor of Obstetrics and Gynecology
I am an OB-GYN and a specialist in maternal-fetal medicine and high-risk obstetrics. My research and publications pertain mainly to the care of women with blood disorders (thrombosis and thrombophilia), bleeding disorders (including von Willebrand disease), platelet disorders (including ITP), and sickle cell disease.
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