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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...

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Autores principales: Naeh, Amir, Hallak, Mordechai, Gabbay-Benziv, Rinat
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
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.
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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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