PDF(Pubmed)
Abstract：
OBJECTIVE: To assess the influence of advanced maternal age on congenital malformations, short- and long-term outcomes in offspring of nulligravida.
METHODS: A retrospective study was conducted using the Korean National Health Insurance Service database spanning from January 2005 to December 2019. All live-born offspring of nulligravida (n=3,685,817) were included. The maternal age was subdivided into the following subgroups: <25 years (n=153,818), 25-29 years (n=845,355), 30-34 years (n=1,738,299), 35-39 years (n=787,530), 40-44 years (n=151,519), and >44 years (n=9,296). Outcomes were assessed based on International Classification of Diseases-10 codes. Adjusted odds ratios (aOR) were calculated with the group of 25-29 years as a reference.
RESULTS: Most congenital malformations showed an age dependent increase, but cleft lip and abdominal wall defect exhibited a U-shape curve, indicating an increase even in those <25 years old. Similarly, various disorders included in the neonatal composite outcomes from short-term outcomes showed aged dependent escalation. However, the preterm birth from the short-term outcome and most of the long-term developmental outcomes, except for motor developmental delay and Tics, showed a U-shaped pattern. The aOR of autism and cerebral palsy, showing the most obvious U-shaped curved in the long-term outcomes, was 1.50 (95% confidence interval [CI], 1.24-1.82) and 1.54 (95% CI, 1.17-2.03), respectively in the group >44 years old and 1.18 (95% CI, 1.11-1.25) and 1.19 (95% CI, 1.09-1.30) in <25 years old group.
CONCLUSIONS: Overall, an advanced maternal age has an age-dependent correlation with most congenital malformations and shortand long-term outcomes of neonates.
METHODS: A retrospective study was conducted using the Korean National Health Insurance Service database spanning from January 2005 to December 2019. All live-born offspring of nulligravida (n=3,685,817) were included. The maternal age was subdivided into the following subgroups: <25 years (n=153,818), 25-29 years (n=845,355), 30-34 years (n=1,738,299), 35-39 years (n=787,530), 40-44 years (n=151,519), and >44 years (n=9,296). Outcomes were assessed based on International Classification of Diseases-10 codes. Adjusted odds ratios (aOR) were calculated with the group of 25-29 years as a reference.
RESULTS: Most congenital malformations showed an age dependent increase, but cleft lip and abdominal wall defect exhibited a U-shape curve, indicating an increase even in those <25 years old. Similarly, various disorders included in the neonatal composite outcomes from short-term outcomes showed aged dependent escalation. However, the preterm birth from the short-term outcome and most of the long-term developmental outcomes, except for motor developmental delay and Tics, showed a U-shaped pattern. The aOR of autism and cerebral palsy, showing the most obvious U-shaped curved in the long-term outcomes, was 1.50 (95% confidence interval [CI], 1.24-1.82) and 1.54 (95% CI, 1.17-2.03), respectively in the group >44 years old and 1.18 (95% CI, 1.11-1.25) and 1.19 (95% CI, 1.09-1.30) in <25 years old group.
CONCLUSIONS: Overall, an advanced maternal age has an age-dependent correlation with most congenital malformations and shortand long-term outcomes of neonates.
摘要：
■为了评估高龄产妇对先天性畸形的影响，以及无效妊娠后代的短期和长期结果。
■使用2005年1月至2019年12月的韩国国家健康保险服务数据库进行了一项回顾性研究。包括nulligravida的所有活产后代（n=3,685,817）。产妇年龄细分为以下亚组：<25岁（n=153,818），25-29岁（n=845,355），30-34岁（n=1,738,299），35-39岁（n=787,530），40-44岁（n=151,519），和>44年（n=9,296）。结果根据ICD-10代码进行评估。使用逻辑回归和Cox比例风险模型分析，以25-29岁的组作为参考计算调整后的比值比（aORs）。
■大多数先天性畸形表现为年龄依赖性增加，唇裂和腹壁缺损呈U型曲线,表明即使在<25岁的人群中也有所增加。同样，来自短期结局的新生儿复合结局中包括的各种疾病显示出年龄依赖性的升级.然而,早产来自短期结果和大多数长期发育结果，除了运动发育迟缓和抽搐,显示U形图案。自闭症和脑瘫的aOR，在长期结果中显示出最明显的U形曲线，分别为1.50(95%CI1.24-1.82)和1.54(95%CI1.17-2.03)，分别在>44岁组和1.18岁(95%置信区间[CI]，<25岁组的1.11-1.25）和1.19（95％CI，1.09-1.30）。
■总的来说，高龄产妇的年龄与大多数先天性畸形呈年龄依赖性，以及新生儿的短期和长期结局。
■使用2005年1月至2019年12月的韩国国家健康保险服务数据库进行了一项回顾性研究。包括nulligravida的所有活产后代（n=3,685,817）。产妇年龄细分为以下亚组：<25岁（n=153,818），25-29岁（n=845,355），30-34岁（n=1,738,299），35-39岁（n=787,530），40-44岁（n=151,519），和>44年（n=9,296）。结果根据ICD-10代码进行评估。使用逻辑回归和Cox比例风险模型分析，以25-29岁的组作为参考计算调整后的比值比（aORs）。
■大多数先天性畸形表现为年龄依赖性增加，唇裂和腹壁缺损呈U型曲线,表明即使在<25岁的人群中也有所增加。同样，来自短期结局的新生儿复合结局中包括的各种疾病显示出年龄依赖性的升级.然而,早产来自短期结果和大多数长期发育结果，除了运动发育迟缓和抽搐,显示U形图案。自闭症和脑瘫的aOR，在长期结果中显示出最明显的U形曲线，分别为1.50(95%CI1.24-1.82)和1.54(95%CI1.17-2.03)，分别在>44岁组和1.18岁(95%置信区间[CI]，<25岁组的1.11-1.25）和1.19（95％CI，1.09-1.30）。
■总的来说，高龄产妇的年龄与大多数先天性畸形呈年龄依赖性，以及新生儿的短期和长期结局。
