Sains Malaysiana 45(10)(2016): 1537–1542

 

Advanced Maternal Age and Adverse Pregnancy Outcomes in Muar, Johor, Malaysia

(Umur Lanjutan Maternal dan Kesan Mudarat Kehamilan di Muar, Johor, Malaysia)

HERNY ERDAWATI MOHD RASHED¹, S MARIA AWALUDDIN*², NOOR ANI AHMAD², NURUL HUDA MD SUPAR¹, ZUBIDAH MD LANI¹, FAUZIAH AZIZ¹, KAMARUL ARIFFIN SULAIMAN¹, RAFEDAH MASENGAT¹, NUR INTAN MOHD ITHNIN¹, ZULKIPLI OTHMAN¹ & TAHIR ARIS²

 

¹Muar Health District Office, Jalan Othman, 84000 Muar, Johor Darul Takzim, Malaysia

 

²Institute for Public Health, Jalan Bangsar, 50590 Kuala Lumpur, Malaysia

 

Received: 15 May 2015/Accepted: 14 January 2016

 

ABSTRACT

Various factors may contribute to adverse pregnancy outcomes; either maternal or foetal outcomes. This study aimed was to determine the association between advanced maternal age and adverse pregnancy outcomes. This is a cross sectional study. Data were collected from the birth records from January 1st 2012 until December 31st 2012 in Muar District. Descriptive and multiple logistic regression analyses were done and the results were presented as adjusted odds ratio (aOR) with p-value <0.05. The proportion of birth in Muar district, Johor was 14.8% among mothers aged 35 years and older and 85.2% among mothers aged 20 to 34 years. Advanced maternal age was associated with pregnancy-induced hypertension (aOR: 5.00; 95%CI: 1.95-12.65), gestational diabetes mellitus (aOR: 2.32; 95%CI: 1.35-4.00) and Caesarean section (aOR: 2.21; 95%CI: 1.53-3.19). Anaemia was negatively associated with advanced maternal age (aOR: 0.50; 95%CI: 0.32-0.78). No significant association was found between advanced maternal age and adverse foetal outcomes. In view of the findings, special attention should be paid to the antenatal mothers aged 35 years and older, even to those without any pre-existing medical problems.

 

Keywords: Adverse pregnancy outcomes; anaemia; maternal age

 

ABSTRAK

Terdapat banyak faktor yang menyumbang kepada kesan mudarat kehamilan sama ada terhadap ibu atau fetus. Kajian ini bertujuan untuk menentukan hubungan antara umur lanjutan maternal dengan kesan mudarat kehamilan. Kajian ini adalah kajian keratan rentas. Data dikumpulkan daripada rekod kelahiran yang berdaftar dari 1 Januari 2012 sehingga 31 Disember 2012 di daerah Muar. Analisis deskriptif dan logistik regresi berganda telah dijalankan dan keputusan dibentangkan sebagai nisbah ganjil terlaras (aOR) dengan nilai p<0.05. Pecahan jumlah kelahiran di daerah Muar, Johor adalah 14.8% dalam kalangan ibu berumur 35 tahun dan ke atas dan 85.2% dalam kalangan ibu berumur 20-34 tahun. Umur lanjutan maternal dikaitkan dengan penyakit darah tinggi semasa mengandung (aOR: 5.00; 95%CI: 1.95-12.65), penyakit kencing manis semasa mengandung (aOR: 2.32; 95%CI: 1.35-4.00) dan pembedahan Caesarean (aOR: 2.21; 95%CI: 1.53-3.19). Anemia pula berhubungan secara negatif dengan umur lanjutan maternal (aOR: 0.50; 95%CI: 0.32-0.78). Tiada hubungan yang signifikan ditemui antara umur lanjutan maternal dan kesan mudarat kepada fetus. Dengan penemuan ini, perhatian istimewa perlu diberikan kepada ibu mengandung pada umur 35 tahun dan ke atas walaupun ibu tersebut tidak mempunyai masalah kesihatan sebelumnya.

 

Kata kunci: Anemia; kesan mudarat kehamilan; umur maternal

REFERENCES

Aghamohammadi, A. & Nooritajer, M. 2011. Maternal age as a risk factor for pregnancy outcomes: Maternal, fetal and neonatal complication. Afr. J. Pharm. Pharmacol. 5: 264-269.

Ahmed, K., Ahmed, S., Handady, S., Alawad, A. & S. Ali, 2015. Advanced maternal age and late pregnancy outcome at Omdurman New Hospital in Sudan. International Journal of Medicine 3(2): Article ID: 5357.

Alem, M., Enawgaw, B., Gelaw, A., Kenaw, T., Seid, M. & Olkeba, Y. 2013. Prevalence of anemia and associated risk factors among pregnant women attending antenatal care in Azezo Health Center Gondar Town, Northwest Ethiopia. Journal of Interdisciplinary Histopathology 1(3): 137-144.

Al-Farsi, Y.M., Brooks, D.R., Werler, M.M., Cabral, H.J., Al- Shafei, M.A. & Wallenburg, H.C. 2011. Effect of high parity on occurrence of anemia in pregnancy: A cohort study. BMC Pregnancy and Childbirth 11(1): 7.

Astolfi, P., De Pasquale, A. & Zonta, L. 2005. Late childbearing and its impact on adverse pregnancy outcome: Stillbirth, preterm delivery and low birth weight. Revue D’épidémiologie et de Santé Publique 53(2): 97-105.

Bayrampour, H., Heaman, M., Duncan, K.A. & Tough, S. 2012. Advanced maternal age and risk perception: A qualitative study. BMC Pregnancy and Childbirth 12(1): 100.

Bayrampour, H. & Heaman, M. 2010. Advanced maternal age and the risk of cesarean birth: A systematic review. Birth 37(3): 219-226.

Biro, M.A., Davey, M-A., Carolan, M. & Kealy, M. 2012. Advanced maternal age and obstetric morbidity for women giving birth in Victoria, Australia: A population-based study. Australian and New Zealand Journal of Obstetrics and Gynaecology 52(3): 229-234.

Bushnik, T. & Rochelle, G. 2008. The Children of Older First-Time Mothers in Canada Their Health and Development. Ottawa: Statistics Canada. http://epe.lac-bac.gc.ca/100/200/301/ statcan/children_youth_research-e/2008/05/89-599- MIE2008005.pdf.

Carolan, M. & Frankowska, D. 2011. Advanced maternal age and adverse perinatal outcome: A review of the evidence. Midwifery 27(6): 793-801.

Cleary-Goldman, J., Malone, F.D., Vidaver, J., Ball, R.H., Nyberg, D.A., Comstock, C.H., Saade, G.R. Eddleman, K.A., Klugman, S., Dugoff, L., Timor-Tritsch, I.E., Craigo, S.D., Carr, S.R., Wolfe, H.M., Bianchi, D.W. & D’Alton, M.; FASTER Consortium. 2005. Impact of maternal age on obstetric outcome. Obstetrics & Gynecology 105(5, Part 1): 983-990.

Cooke, A., Mills, T.A. & Lavender, T. 2012. Advanced maternal age: Delayed childbearing is rarely a conscious choice a qualitative study of women’s views and experiences. International Journal of Nursing Studies 49(1): 30-39.

Rosniza Aznie, C.R., Usman, Y., Suriati, G., Abdul Rahim, M.N., Rosmiza, M.Z., Lyndon, N., Mohd Fuad, M.J., Mohd Yusof Hussain, Zaimah, R. & Sarmila, M.S. 2013. Identifying potential factors of ideal childbearing among Malay women in Terengganu. Asian Social Science 9(8): 79-86.

Delbaere, I., Verstraelen, H., Goetgeluk, S., Martens, G., De Backer, G. & Temmerman, M. 2007. Pregnancy outcome in primiparae of advanced maternal age. European Journal of Obstetrics & Gynecology and Reproductive Biology 135(1): 41-46.

Dim, C.C. & Onah, H.E. 2007. The prevalence of anemia among pregnant women at booking in Enugu, South Eastern Nigeria. Medscape General Medicine 9(3): 11.

Fretts, R.C. 2005. Etiology and prevention of stillbirth. American Journal of Obstetrics and Gynecology 193(6): 1923-1935.

Gravena, A.A.F., de Paula, M.G., Marcon, S.S., de Carvalho, M.D.B. & Pelloso, S.M. 2013. Maternal age and factors associated with perinatal outcomes. Acta Paulista de Enfermagem 26(2): 130-135.

Haniff, J., Das, A., Lim T.O., Chen W.S., Mohd Nordin, N., Rampal, S., Bahrin, S., Ganeslingam, M., Kularatnam, K.I. & Zaher, Z.M. 2006. Anemia in pregnancy in Malaysia: A cross-sectional survey. Asia Pacific Journal of Clinical Nutrition 16(3): 527-536.

Hoque, M.E. 2012. Advanced maternal age and outcomes of pregnancy: A retrospective study from South Africa. Biomedical Research 23(2): 281-285.

Joseph, K.S., A.C., Allen, L., Dodds, L.A., Turner, Scott, H. & Liston, R. 2005. The perinatal effects of delayed childbearing. Obstetrics and Gynaecology 105(6): 1410-1418.

Kenny, L.C., Lavender, T., McNamee, R., O’Neill, S.M., Mills, T. & Khashan, A.S. 2013. Advanced maternal age and adverse pregnancy outcome: Evidence from a large contemporary cohort. PLoS ONE 8(2): e56583.

Khalil, A., Syngelaki, A., Maiz, N., Zinevich, Y. & Nicolaides, K.H. 2013. Maternal age and adverse pregnancy outcome: A cohort study: Maternal age and pregnancy complications. Ultrasound in Obstetrics & Gynecology 42(6): 634-643.

Laopaiboon, M., Lumbiganon, P., Intarut, N., Mori, R., Ganchimeg, T., Vogel, J.P., Souza, J.P., Gülmezoglu, A.M. and on behalf of the WHO Multicountry Survey on Maternal Newborn Health Research Network. 2014. Advanced maternal age and pregnancy outcomes: A multicountry assessment. BJOG: An International Journal of Obstetrics & Gynaecology 121(March): 49-56.

Lisonkova, S., Janssen, P.A., Sheps, S.B., Lee, S.K. & Dahlgren, L. 2010. The effect of maternal age on adverse birth outcomes: Does parity matter. J. Obstet. Gynaecol. Can. 32(6): 541-548.

Luke, B. & Brown, M.B. 2007. Elevated risks of pregnancy complications and adverse outcomes with increasing maternal age. Human Reproduction 22(5): 1264-1272.

Mathews, T.J. & Hamilton, B.E. 2009. Delayed childbearing: More women are having their first child later in life : NCHS data brief. Centers for Disease Control and Prevention. http:// www.cdc.gov/nchs/data/databriefs/db21.htm.

Matsuda, Yoshio, Yayoi Kawamichi, Kunihiko Hayashi, Arihiro Shiozaki, Shoji Satoh, and Shigeru Saito. 2011. Impact of maternal age on the incidence of obstetrical complications in Japan. Journal of Obstetrics and Gynecology Research 37(10): 1409-1414.

Ministry of Health Malaysia. 2015. Pre Pregnancy Care (PPC). MyHealth Ministry of Health Malaysia. http://www.myhealth. gov.my/index.php/en/prime-years/reproductive-health/pre-pregnancy-care-ppc.

Rajee Minoo, Sareh Amirzadeh, Fariba Mirblook & Mitra Ahmad Soltani. 2010. The effect of maternal age on pregnancy outcome. Asian Journal of Medical Sciences 2(3): 159-162.

Schimmel, M.S., Bromiker, R., Hammerman, C., Chertman, L., Ioscovich, A., Granovsky-Grisaru, S., Samueloff, A. & Elstein, D. 2014. The effects of maternal age and parity on maternal and neonatal outcome. Archives of Gynecology and Obstetrics 291(4): 793-798.

UNICEF. 2011. Malaysia: The Millennium Development Goals at 2010. Kuala Lumpur: United Nations Country Team, Malaysia.

Villar, J., Carroli, G., Khan-Neelofur, D., Piaggio, G. & Gulmezoglu, M. 2001. Patterns of routine antenatal care for low-risk pregnancy. Cochrane Database Syst. Rev. 2001(4): CD000934.

Wang, Y., Tanbo, T., Åbyholm, T. & Henriksen, T. 2011. The impact of advanced maternal age and parity on obstetric and perinatal outcomes in singleton gestations. Archives of Gynecology and Obstetrics 284(1): 31-37.

Yadav, H. & Lee, N. 2013. Maternal factors in predicting low birth weight babies. The Medical Journal of Malaysia 68(1): 44-47.

 

 

*Corresponding author; email: smaria@moh.gov.my