MedicalResearch.com Interview with:
Sarka Lisonkova, MD, PhD
Department of Obstetrics and Gynaecology,
University of British Columbia.
Children’s and Women’s Health Centre
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Adverse fetal and infant outcomes associated with maternal age were known and our study confirms that the risk of fetal and neonatal death and severe neonatal morbidity increases among mothers over 30 years. We also knew that older mothers are more likely to have hypertension, diabetes, and other chronic diseases, and they are more likely to develop gestational diabetes, hypertension during pregnancy, and preeclampsia. These complications may put the fetus or newborn at risk, but are generally not considered to be potentially life threatening to the mother. Our study adds new information on the rates of severe maternal morbidities that have a high case-fatality rate, lead to organ damage, or have serious health implications such as hysterectomy. Our study also adds the information on the rates of any severe adverse birth outcome – for baby or mom – in the association with maternal age, which is important for counseling. Women usually want to know ‘what are the chances that anything bad happens’.
MedicalResearch.com: What should readers take away from your report?
Response: Women are in difficult position when they contemplate delaying childbirth in order to advance their education and career. Higher education and higher socio-economic status are associated with improved birth outcomes, in contrast, older maternal age is a risk factor. The current counseling with respect to delayed childbearing focuses mainly on increased fertility problems, risk of miscarriage, fetal and newborn death and neonatal morbidity. Women usually worry about their babies, and not so much about the implications for their own health. And while severe adverse conditions in mothers are rare, they do increase with age more rapidly at childbirth in late forties or later. It is important to counsel women about all potential risks and our study provides detailed information.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Our finding of elevated risk of sepsis among younger mothers was unexpected. We hypothesize that because young women are generally healthy, they may not show the typical signs of advancing infection. Thus the administration of antibiotics may be delayed resulting in sepsis. We need to further examine reasons behind this association, meanwhile, however, physicians should be aware of this potential complication among young mothers.
MedicalResearch.com: Is there anything else you would like to add?
Response: We all age differently and that is also true for reproductive aging. Our study shows that, on average, the rates of adverse maternal and baby outcomes are lowest in late twenties or early thirties. Healthy lifestyle can lower the odds of complications at any age. Proper prenatal care and childbirth plan are important for older mothers, knowing that timely obstetric intervention may be needed.
No conflicts of interest
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Sarka Lisonkova, Jayson Potts, Giulia M. Muraca, Neda Razaz, Yasser Sabr, Wee-Shian Chan, Michael S. Kramer. Maternal age and severe maternal morbidity: A population-based retrospective cohort study. PLOS Medicine, 2017; 14 (5): e1002307 DOI: 10.1371/journal.pmed.1002307
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