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Parity and Interval from Previous Delivery—Influence on Perinatal Outcome in Advanced Maternal Age Parturients
Objective: To investigate the effect of parity and interpregnancy interval (IPI) on perinatal outcomes in advanced maternal age (AMA) parturients. Methods: A population-based retrospective cohort study of all women older than 40 years, who had a singleton live birth after 24 weeks in the United Stat...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7865726/ https://www.ncbi.nlm.nih.gov/pubmed/33530313 http://dx.doi.org/10.3390/jcm10030460 |
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author | Naeh, Amir Hallak, Mordechai Gabbay-Benziv, Rinat |
author_facet | Naeh, Amir Hallak, Mordechai Gabbay-Benziv, Rinat |
author_sort | Naeh, Amir |
collection | PubMed |
description | Objective: To investigate the effect of parity and interpregnancy interval (IPI) on perinatal outcomes in advanced maternal age (AMA) parturients. Methods: A population-based retrospective cohort study of all women older than 40 years, who had a singleton live birth after 24 weeks in the United States in 2017 Women were categorized to three groups by parity and interval from last delivery: primiparas, multiparas with IPI ≤ 5 years, and multiparas with IPI > 5 years. Primary outcome was composite adverse neonatal outcome (preterm delivery <34 weeks, birthweight <2000 g, neonatal seizure, neonatal intensive care unit admission, Apgar score <7 at 5 min, or assisted ventilation >6 h). Secondary outcome was composite adverse maternal outcome and other adverse perinatal outcomes. Univariate and multivariate analysis were used to compare between groups. Results: During 2017, 3,864,754 deliveries were recorded into the database. Following exclusion, 109,564 AMA gravidas entered analysis. Of them, 24,769 (22.6%) were nulliparas, 39,933 (36.4%) were multiparas with IPI ≤ 5 years, and 44,862 (40.9%) were multiparas with IPI > 5 years. Composite neonatal outcome was higher in nulliparas and in multiparas with IPI > 5 years, in comparison to multiparas with IPI ≤ 5 years (16% vs. 13% vs. 10%, respectively, p < 0.05). Maternal composite outcome was similar between groups. In the multivariable analysis, relative to nulliparas, only multiparity with IPI ≤ 5 years had a protective effect against the composite neonatal outcome (aOR 0.97, 95% CI 0.95–0.99, p < 0.001). Conclusion: Among AMA gravidas, multiparity with IPI ≤ 5 years has a significant protective effect against adverse neonatal outcomes when compared to nulliparas. Multiparity with IPI > 5 years is no longer protective. |
format | Online Article Text |
id | pubmed-7865726 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-78657262021-02-07 Parity and Interval from Previous Delivery—Influence on Perinatal Outcome in Advanced Maternal Age Parturients Naeh, Amir Hallak, Mordechai Gabbay-Benziv, Rinat J Clin Med Article Objective: To investigate the effect of parity and interpregnancy interval (IPI) on perinatal outcomes in advanced maternal age (AMA) parturients. Methods: A population-based retrospective cohort study of all women older than 40 years, who had a singleton live birth after 24 weeks in the United States in 2017 Women were categorized to three groups by parity and interval from last delivery: primiparas, multiparas with IPI ≤ 5 years, and multiparas with IPI > 5 years. Primary outcome was composite adverse neonatal outcome (preterm delivery <34 weeks, birthweight <2000 g, neonatal seizure, neonatal intensive care unit admission, Apgar score <7 at 5 min, or assisted ventilation >6 h). Secondary outcome was composite adverse maternal outcome and other adverse perinatal outcomes. Univariate and multivariate analysis were used to compare between groups. Results: During 2017, 3,864,754 deliveries were recorded into the database. Following exclusion, 109,564 AMA gravidas entered analysis. Of them, 24,769 (22.6%) were nulliparas, 39,933 (36.4%) were multiparas with IPI ≤ 5 years, and 44,862 (40.9%) were multiparas with IPI > 5 years. Composite neonatal outcome was higher in nulliparas and in multiparas with IPI > 5 years, in comparison to multiparas with IPI ≤ 5 years (16% vs. 13% vs. 10%, respectively, p < 0.05). Maternal composite outcome was similar between groups. In the multivariable analysis, relative to nulliparas, only multiparity with IPI ≤ 5 years had a protective effect against the composite neonatal outcome (aOR 0.97, 95% CI 0.95–0.99, p < 0.001). Conclusion: Among AMA gravidas, multiparity with IPI ≤ 5 years has a significant protective effect against adverse neonatal outcomes when compared to nulliparas. Multiparity with IPI > 5 years is no longer protective. MDPI 2021-01-26 /pmc/articles/PMC7865726/ /pubmed/33530313 http://dx.doi.org/10.3390/jcm10030460 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Naeh, Amir Hallak, Mordechai Gabbay-Benziv, Rinat Parity and Interval from Previous Delivery—Influence on Perinatal Outcome in Advanced Maternal Age Parturients |
title | Parity and Interval from Previous Delivery—Influence on Perinatal Outcome in Advanced Maternal Age Parturients |
title_full | Parity and Interval from Previous Delivery—Influence on Perinatal Outcome in Advanced Maternal Age Parturients |
title_fullStr | Parity and Interval from Previous Delivery—Influence on Perinatal Outcome in Advanced Maternal Age Parturients |
title_full_unstemmed | Parity and Interval from Previous Delivery—Influence on Perinatal Outcome in Advanced Maternal Age Parturients |
title_short | Parity and Interval from Previous Delivery—Influence on Perinatal Outcome in Advanced Maternal Age Parturients |
title_sort | parity and interval from previous delivery—influence on perinatal outcome in advanced maternal age parturients |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7865726/ https://www.ncbi.nlm.nih.gov/pubmed/33530313 http://dx.doi.org/10.3390/jcm10030460 |
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