American Journal of Obstetrics and Gynecology
Poster session II385: Mode of delivery in women of extremely advanced maternal age
Section snippets
Objective
To examine vaginal and cesarean delivery rates in women of extremely advanced maternal age.
Study Design
This is a retrospective cohort study of all deliveries in women >30 years in the state of California between 2007-2011. Data were extracted from maternal discharge information linked to infant birth certificate records. Maternal age was categorized into 5 groups (30-34, 35-39, 40- 44, 44-49, and >50 years) and women aged 30-34 years were the reference group. Rates of labor and cesarean delivery were studied across age groups and stratified by parity and multiple gestations.
Results
During the study period, there were 654,150 deliveries to women >30 years, of which 343 (0.02% of total) were to women >50 years. Of the entire cohort, 27.2% were nulliparous and 4.4% were multiple gestations. Nulliparity declined between ages 30-34 (p<0.001) and increased after age 45 (p<0.001). Multiple gestations increased significantly over all age groups from 3.6% in women 30-44 years to 47.5% in women >50 years (p<0.001). For the entire cohort, the cesarean delivery rate was 39.4% and was
Conclusion
Compared to younger women, women of extremely advanced maternal age experience significantly higher rates of cesarean delivery. However many women >50 years who labor may achieve a vaginal delivery. These data support a trial of labor in women >50 years.