Advanced maternal age and neonatal outcomes in Malta

Abstract

Introduction: During the past three decades, significant increases in childbirth at advanced maternal age (AMA) have been noted in different high-income countries. Objective: The aim of this study is to assess for the association between AMA and different neonatal outcomes in Malta. Multivariate regression analysis was carried out. Materials and Methods: Data was derived from the National Obstetric Information System. All mothers of 20 years and older, who delivered singleton babies in Malta and Gozo between 1st January 2000 and 31st December 2014 were studied. Results: The study population included 55,943 singleton births. Our results clearly show that the percentage of preterm babies increased and the birth weight decreased with advancing maternal age. The adjusted rates of stillbirths and rates of infants that died in less than 28 days also increased with age. A significant increase in chromosomal abnormalities was also detected in mothers over 40 years. Conclusion: This study demonstrates that AMA in Malta significantly increases the risk for preterm births, low birth weight, still births and neonatal deaths. The set-up of a multidisciplinary specialized clinic may prove useful in improving outcome in pregnancies of women with AMA.