Adverse perinatal outcomes for advanced maternal age: A cross-sectional study of Brazilian births

Objectives to investigate the risk of adverse perinatal outcomes in women aged ≥41 years relatively to those aged 21-34. methods approximately 8.5 million records of singleton births in brazilian hospitals in the period 2004-2009 were investigated. odds ratios were estimated for preterm and post-term births,for low apgar scores at 1 min and at 5 min,for asphyxia,for low birth weight,and for macrosomia. results for pregnant women ≥41,increased risks were identified for preterm births,for post-term births (except for primiparous women with schooling ≥12 years),and for low birth weight. when comparing older vs. younger women,higher educational levels ensure similar risks of low apgar score at 1 min (for primiparous mothers and term births),of low apgar score at 5 min (for term births),of macrosomia (for non-primiparous women),and of asphyxia. conclusion as a rule,older mothers are at higher risk of adverse perinatal outcomes,which,however,may be mitigated or eliminated,depending on gestational age,parity,and,especially,on the education level of the pregnant woman. © 2015 sociedade brasileira de pediatria.