GIVE IT TIME
Study shows corelation between maternal age and premature labour; ages 30-34 being at least risk
Impact of advanced maternal age on preterm birth
Pregnancy normally lasts about 40 weeks, and babies born after 37 weeks are considered full term. In the weeks immediately after birth, preterm babies often have difficulty in breathing and digesting food. They can also encounter longterm challenges such as impaired vision, hearing and cognitive skills, as well as social and behavioural problems. Preterm babies have higher risks of heart defects, lung disorders, cerebral palsy, and delayed development. According to WHO statistics, every year, an estimated 15 million babies are born preterm and this number is rising. Complications due to preterm births are the leading cause of death among children less than five years. Across 184 countries, the rate of preterm birth ranges from 5 per cent to 18 per cent . QUARISMA study, a large Canadian randomised controlled trial, which collected data from 184,000 births in 32 hospitals, showed that the trend of risk of premature delivery follows a U-shaped distribution: It is higher before 30 years and after 40 years, and at its lowest between 30 and 34. Women between 20 and 24 years had 6.8 per cent chance of preterm delivery, the likelihood was 6 per cent for mothers between 25 and 29, 6.3% for mothers between 35 and 39 and 7.8 per cent for women over 40 years. Women between 30 and 34 had the lowest risk for a preterm delivery, at 5.7 per cent. Overall, women in their 30’s have a lower risk of giving birth prematurely than women in their 20’s. This offers fresh evidence that age is an independent risk factor for preterm births, the researchers concluded in PLoS One. Pregnancy in teenage and very young women is generally considered to be at very high-risk because these women are physically and psychologically immature for reproduction. In addition, there are some extrinsic factors such as inadequate prenatal care, illiteracy and poor socioeconomic conditions that affect the outcome of pregnancy. Several medical complications like preterm birth, poor maternal weight gain, pregnancy-induced hypertension, anaemia, and sexually transmitted diseases are strongly associated with
teenage pregnancy. It is suggested that these young women, who are still themselves growing, may compete with the foetus for nutrients, which may in turn impair foetal growth and result in low birthweight babies or babies who are small for their gestational age. There is increased neonatal mortality associated with young maternal age. Lifestyle and sociodemographic factors such as smoking, alcohol use, low body mass index and social deprivation have all been shown to contribute to less favourable birth outcomes. It is also established that adolescent mothers in high-income countries are at higher risk of exhibiting these characteristics. The underutilisation of antenatal care by adolescent mother is again an important factor which determines the outcome of teenage pregnancy. According to the above mentioned study, stress may also have contributed to the higher risk of preterm birth observed in women who had multiple births at a young age (20–24 years). Compared with the reference group (25–29 years), these women were more exposed to factors related to social vulnerability including low level of education, country of birth, and smoking. The preterm birth in the 20-24 year age group was mainly spontaneous rather than that induced for medical complications of pregnancy. There has been a considerable trend in the society nowadays with women opting for maternity in their late 30s. Free access to abortion and better contraceptives have made it a lot easier for women to choose when they want children and how many. Also, more education and employment opportunities have given women greater economic independence. Other societal changes, such as increasing women’s liberation and broader acceptance of cohabitation also contribute largely to these changes. Advanced maternal age increased the risks of both spontaneous and indicated very preterm births. Increased maternal age may contribute to the placental and vascular problems associated with preterm birth. Hypertension complicating pregnancy and small babies are associated with vascular disorders and decreased utero placental blood flow. Progesterone is important for pregnancy maintenance and this hormone levels decline with maternal age which might be again another factor responsible for the preterm births. Preterm infant survival is high nowadays, and the survival rate has also increased for those born extremely preterm. But very preterm infants is one of the most resource demanding in hospital patient groups and the final outcome is not always full health. To challenge these issues, increased professional and political knowledge as well as parental and public information on the increased risk for preterm birth is warranted.
Increased maternal age may contribute to the placental and vascular problems associated with preterm birth