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Twin pregnancy in women above the age of 45 years: maternal and neonatal outcomes

  • Tomer Avnon , Alon Haham and Ariel Many EMAIL logo
Published/Copyright: November 2, 2016
Journal of Perinatal Medicine
From the journal Journal of Perinatal Medicine Volume 45 Issue 7

Abstract

Childbearing age continues to rise and, with the increasing implementation of assisted reproductive technology (ART), the number of multiple pregnancies has also risen. This is a retrospective cohort study on maternal and neonatal outcomes of the twin pregnancies of 57 women aged ≥45 years compared to 114 younger women who gave birth in our institution between January 2011 and August 2015. Data were extracted from the real-time computerized database. The rates of hypertensive complications and pre-eclampsia (PE) were much higher in the study group compared to the controls (24/57 vs. 19/114, P=0.000 and 15/57 vs. 13/114, P=0.013, respectively). The respective incidence of very low birth weight (VLBW) was also significantly higher (14/114 vs. 12/228, P=0.021). Infants in the study group required four times more intubation and had a higher admission rate to the neonatal intensive care unit (NICU) compared to control infants (14/114 vs. 6/228 P=0.000 and 42/114 vs. 57/228, P=0.023, respectively). We conclude that women older than 45 years with twin pregnancies have higher maternal and perinatal complications with worse outcomes in comparison with younger women. When pregnancy is attempted via ART, embryo transfer of only one embryo should be considered in this age group.

Keywords: Assisted reproductive technology; neonatal intensive care unit; pre-eclampsia; pre-term delivery; twin pregnancy; very advanced maternal age; very low birth weight
Corresponding author: Ariel Many, MD, Department of Obstetrics and Gynecology, Lis Maternity and Women’s Hospital, Tel-Aviv Sourasky Medical Center, 6 Weizmann Street, Tel-Aviv 6423906, Israel, Phone: +972-3-6925603, Fax: +972-3-6925721

Acknowledgments

The authors report no conflicts of interest.

Author’s statement

  1. Conflict of interest: Authors state no conflict of interest.

  2. Material and methods: Informed consent: Informed consent has been obtained from all individuals included in this study.

  3. Ethical approval: The research related to human subject use has complied with all the relevant national regulations, and institutional policies, and is in accordance with the tenets of the Helsinki Declaration, and has been approved by the authors’ institutional review board or equivalent committee.

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Received: 2016-6-2
Accepted: 2016-9-29
Published Online: 2016-11-2
Published in Print: 2017-10-26

©2017 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Preeclampsia and intrauterine growth restriction: placental disorders still not fully understood
  4. Review article
  5. Hepar uterinum: a history of ideas on fetal nutrition
  6. Original articles
  7. Twin pregnancy in women above the age of 45 years: maternal and neonatal outcomes
  8. Maternal endothelial damage as a disorder shared by early preeclampsia, late preeclampsia and intrauterine growth restriction
  9. Maternal venous SHARP1 levels in preeclampsia
  10. Second-trimester maternal serum markers in the prediction of preeclampsia
  11. Pregnancy outcomes regarding maternal serum AFP value in second trimester screening
  12. Quantification of mechanical dyssynchrony in growth restricted fetuses and normal controls using speckle tracking echocardiography (STE)
  13. Serum cholesterol acceptor capacity in intrauterine growth restricted fetuses
  14. Antithrombin improves the maternal and neonatal outcomes but not the angiogenic factors in extremely growth-restricted fetuses at <28 weeks of gestation
  15. Simple approach based on maternal characteristics and mean arterial pressure for the prediction of preeclampsia in the first trimester of pregnancy
  16. Fetal death: an extreme manifestation of maternal anti-fetal rejection
  17. Intrauterine growth restriction and placental gene expression in severe preeclampsia, comparing early-onset and late-onset forms
  18. The relationship between maternal and umbilical cord adropin levels with the presence and severity of preeclampsia
  19. Expression of placental regulatory genes is associated with fetal growth
  20. Circulating soluble fms-like tyrosine kinase-1 and placental growth factor from 10 to 40 weeks’ pregnancy in normotensive women
  21. A one year review of eclampsia in an Ethiopian Tertiary Care Center (Saint Paul’s Hospital Millennium Medical College, SPHMMC)
  22. Congress Calendar
  23. Congress Calendar
https://doi.org/10.1515/jpm-2016-0196
Keywords for this article
Assisted reproductive technology; neonatal intensive care unit; pre-eclampsia; pre-term delivery; twin pregnancy; very advanced maternal age; very low birth weight

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Preeclampsia and intrauterine growth restriction: placental disorders still not fully understood
  4. Review article
  5. Hepar uterinum: a history of ideas on fetal nutrition
  6. Original articles
  7. Twin pregnancy in women above the age of 45 years: maternal and neonatal outcomes
  8. Maternal endothelial damage as a disorder shared by early preeclampsia, late preeclampsia and intrauterine growth restriction
  9. Maternal venous SHARP1 levels in preeclampsia
  10. Second-trimester maternal serum markers in the prediction of preeclampsia
  11. Pregnancy outcomes regarding maternal serum AFP value in second trimester screening
  12. Quantification of mechanical dyssynchrony in growth restricted fetuses and normal controls using speckle tracking echocardiography (STE)
  13. Serum cholesterol acceptor capacity in intrauterine growth restricted fetuses
  14. Antithrombin improves the maternal and neonatal outcomes but not the angiogenic factors in extremely growth-restricted fetuses at <28 weeks of gestation
  15. Simple approach based on maternal characteristics and mean arterial pressure for the prediction of preeclampsia in the first trimester of pregnancy
  16. Fetal death: an extreme manifestation of maternal anti-fetal rejection
  17. Intrauterine growth restriction and placental gene expression in severe preeclampsia, comparing early-onset and late-onset forms
  18. The relationship between maternal and umbilical cord adropin levels with the presence and severity of preeclampsia
  19. Expression of placental regulatory genes is associated with fetal growth
  20. Circulating soluble fms-like tyrosine kinase-1 and placental growth factor from 10 to 40 weeks’ pregnancy in normotensive women
  21. A one year review of eclampsia in an Ethiopian Tertiary Care Center (Saint Paul’s Hospital Millennium Medical College, SPHMMC)
  22. Congress Calendar
  23. Congress Calendar
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