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Medical and obstetric complications among pregnant women aged 45 and older.

dc.contributor.author Brown, HL
dc.contributor.author Chisholm, CA
dc.contributor.author Grotegut, Chad Aaron
dc.contributor.author Heine, RP
dc.contributor.author James, Andra Hohler
dc.contributor.author Johnson, LN
dc.coverage.spatial United States
dc.date.accessioned 2015-12-04T19:30:04Z
dc.date.issued 2014
dc.identifier http://www.ncbi.nlm.nih.gov/pubmed/24769856
dc.identifier PONE-D-13-19889
dc.identifier.uri http://hdl.handle.net/10161/11092
dc.description.abstract 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.
dc.language eng
dc.relation.ispartof PLoS One
dc.relation.isversionof 10.1371/journal.pone.0096237
dc.subject Adult
dc.subject Female
dc.subject Humans
dc.subject Linear Models
dc.subject Logistic Models
dc.subject Maternal Age
dc.subject Middle Aged
dc.subject Multivariate Analysis
dc.subject Pregnancy
dc.subject Pregnancy Complications
dc.subject Pregnancy Outcome
dc.subject Prevalence
dc.subject Risk Factors
dc.subject Survival Analysis
dc.subject United States
dc.title Medical and obstetric complications among pregnant women aged 45 and older.
dc.type Journal article
pubs.author-url http://www.ncbi.nlm.nih.gov/pubmed/24769856
pubs.begin-page e96237
pubs.issue 4
pubs.organisational-group Clinical Science Departments
pubs.organisational-group Duke
pubs.organisational-group Medicine
pubs.organisational-group Medicine, Hematology
pubs.organisational-group Midwifery Service
pubs.organisational-group Obstetrics and Gynecology
pubs.organisational-group Obstetrics and Gynecology, Maternal Fetal Medicine
pubs.organisational-group Pediatrics
pubs.organisational-group School of Medicine
pubs.organisational-group School of Nursing
pubs.organisational-group School of Nursing - Secondary Group
pubs.publication-status Published online
pubs.volume 9
dc.identifier.eissn 1932-6203


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