Maternal age and malformations in singleton births

doi:10.1016/S0029-7844(00)01019-X

Obstetrics & Gynecology

Volume 96, Issue 5, Part 1, November 2000, Pages 701-706

https://doi.org/10.1016/S0029-7844(00)01019-X Get rights and content

Abstract

Objective: To examine the effect of maternal age on incidence of nonchromosomal fetal malformations.

Methods: Malformations detected at birth or in the newborn nursery were catalogued prospectively for 102,728 pregnancies, including abortions, stillbirths, and live births, from January 1, 1988 to December 31, 1994. Maternal age was divided into seven epochs. Relative risks (RRs) were used to compare demographic variables and specific malformations. The Mantel-Haenszel χ² statistic was used to compare age-specific anomalies. Multiple logistic regression analysis was used to adjust for parity.

Results: Abnormal karyotypes were significantly more frequent in older women. After excluding infants with chromosomal abnormalities, the incidence of structurally malformed infants also was increased significantly and progressively in women 25 years of age or older. The additional age-related risk of nonchromosomal malformations was approximately 1% in women 35 years of age or older. The odds ratio for cardiac defects was 3.95 in infants of women 40 years of age or older (95% CI 1.70, 9.17) compared with women aged 20–24 years. The risks of clubfoot and diaphragmatic hernia also increased as maternal age increased.

Conclusion: Advanced maternal age beyond 25 years was associated with significantly increased risk of fetuses having congenital malformations not caused by aneuploidy.

Section snippets

Materials and methods

Parkland Health and Hospital System is a public institution that serves women primarily of Dallas County. The obstetric service is staffed by residents, fellows, and faculty of the Department of Obstetrics and Gynecology of the University of Texas Southwestern Medical Center, Dallas, Texas. Our 7-year study of singleton births included calendar years 1988 through 1994. The start date coincided with the incorporation of maternal serum alpha-fetoprotein (AFP) screening with other prenatal

Results

From 1988 to 1994, 102,728 singleton pregnancies met inclusion criteria and were analyzed. As shown in Table 1, those included 101,198 live infants who weighed more than 500 g. Among those, 3466 (3%) had structural malformations not caused by chromosomal abnormalities and 155 had abnormal karyotypes. There were 829 stillbirths during that period, 104 (12%) with at least one malformation and 16 with confirmed abnormal karyotypes. Another 701 women had spontaneous or induced second-trimester

Discussion

Our analysis offers at least three important findings about congenital malformations. We confirmed the well-known association of increased maternal age with chromosomal aberrations, especially aneuploidies. Also, women who were 25 years of age or older at delivery had significantly and progressively greater risk of having fetuses with nonchromosomal malformations compared with women 20–24 years old. By age 35 years, the additional age-related risk of having infants with nonchromosomal

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Maternal age and malformations in singleton births

Abstract

Section snippets

Materials and methods

Results

Discussion

Lancet

Fertil Steril

Lancet

Rates of chromosome abnormalities at different maternal ages

Obstet Gynecol