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Maternal Age and Risk of Labor and Delivery Complications

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Abstract

We utilized an updated nationally representative database to examine associations between maternal age and prevalence of maternal morbidity during complications of labor and delivery. We used hospital inpatient billing data from the 2009 United States Nationwide Inpatient Sample, part of the Healthcare Cost and Utilization Project. To determine whether the likelihood that maternal morbidity during complications of labor and delivery differed among age groups, separate logistic regression models were run for each complication. Age was the main independent variable of interest. In analyses that controlled for demographics and clinical confounders, we found that complications with the highest odds among women, 11–18 years of age, compared to 25–29 year old women, included preterm delivery, chorioamnionitis, endometritis, and mild preeclampsia. Pregnant women who were 15–19 years old had greater odds for severe preeclampsia, eclampsia, postpartum hemorrhage, poor fetal growth, and fetal distress. Pregnant women who were ≥35 years old had greater odds for preterm delivery, hypertension, superimposed preeclampsia, severe preeclampsia, and decreased risk for chorioamnionitis. Older women (≥40 years old) had increased odds for mild preeclampsia, fetal distress, and poor fetal growth. Our findings underscore the need for pregnant women to be aware of the risks associated with extremes of age so that they can watch for signs and symptoms of such complications.

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Acknowledgments

This publication was made possible by Grant Numbers UL1 RR024992 and KL2 RR024994 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research. This work was funded in part by Washington University Institute of Clinical and Translational Sciences grant UL1 TR000448 from the National Center for Advancing Translational Sciences (NIH) and by Grant Number R24 HS19455 (PI: V. Fraser) from the Agency for Healthcare Research and Quality (AHRQ). Other support includes an NIH Career Development Award awarded to Dr. Cavazos-Rehg (NIDA, K01DA025733), and an NIH Midcareer Investigator Award awarded to Dr. Bierut (K02 DA021237).

Conflict of interest

Dr. Madden receives research support from Merck and Co, Inc. and honorarium from Bayer Healthcare Pharmaceuticals. Dr. Peipert receives research support from Merck and Bayer Healthcare Pharmaceuticals Co, Inc. and served on an advisory board for Teva. Dr. Bierut is listed as an inventor on Issued U.S. Patent 8,080,371, “Markers for Addiction” covering the use of certain SNPs in determining the diagnosis, prognosis, and treatment of addiction.

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Authors and Affiliations

  1. Department of Psychiatry, Washington University School of Medicine, Campus Box 8134, 660 South Euclid, St. Louis, MO, 63110, USA

    Patricia A. Cavazos-Rehg, Melissa J. Krauss & Laura Jean Bierut

  2. Department of Mathematics, Washington University in St. Louis, St. Louis, MO, 63130, USA

    Edward L. Spitznagel

  3. Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, MO, 63110, USA

    Kerry Bommarito, Margaret A. Olsen & Harini Subramaniam

  4. Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, 63110, USA

    Tessa Madden & Jeffrey F. Peipert

  5. Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, 63110, USA

    Margaret A. Olsen

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  1. Patricia A. Cavazos-Rehg
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  2. Melissa J. Krauss
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Correspondence to Patricia A. Cavazos-Rehg.

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Cavazos-Rehg, P.A., Krauss, M.J., Spitznagel, E.L. et al. Maternal Age and Risk of Labor and Delivery Complications. Matern Child Health J 19, 1202–1211 (2015). https://doi.org/10.1007/s10995-014-1624-7

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