| Abstract [eng] |
Nowadays, more women delay childbearing into their forties or even fifties due to several reasons like the greater availability of contraceptive methods, better fertility treatment options and the greater availability of socioeconomic resources. Together with this demographic shift in childbearing over time, some pregnancy related complications were found to occur more often in pregnant women aged 40 years and above. Women of advanced maternal age are at higher risk for fetal chromosomal abnormalities, spontaneous abortions, placenta previa, preterm delivery and stillbirth (1–5). Moreover, they tend to have more often pre-existing comorbidities like diabetes mellitus and hypertension that might lead to serious complications as for example preeclampsia (6,7). All the complications contribute to a higher perinatal mortality in women of advanced maternal age hence it is important to adjust current pregnancy monitoring algorithms and develop new recommendations. While most studies review disadvantages of pregnancies at advanced maternal age, some advantages can be described. The advantages are based primarily on the improvements over time that affect children born to a later birth cohort as long-term trends are positive for many important outcomes (8). Furthermore, due to sociodemographic changes women of advanced maternal age nowadays have a higher educational level, are more often employed, and have a higher income compared with their younger counterparts. Some studies even suggest that the advantages, to a degree, may counterbalance the biological disadvantages (9). |
