| The influence of advanced maternal age on congenital malformations, short- and long-term outcomes in offspring of nulligravida: a Korean National Cohort Study over 15 years |
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Su Jin You1, Danbee Kang2,3, Ji-Hee Sung1, Hyejeong Park3, Juhee Cho2,3, Suk-Joo Choi1, Soo-Young Oh1, Cheong-Rae Roh1 |
1Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
2Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University, Seoul, Korea
3Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Korea |
Correspondence:
Juhee Cho,
Soo-Young Oh,
Email: ohsymd@skku.edu
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Received: 1 August 2023 • Revised: 8 March 2024 • Accepted: 15 April 2024
*Su Jin You and Danbee Kang contributed equally to this study as co-first authors. |
| Abstract |
Objective
To assess the influence of advanced maternal age on congenital malformations, and 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 ICD-10 codes. Adjusted odds ratios (aORs) were calculated with the group of 25-29 years as a reference using logistic regression and Cox proportional hazards model analysis.
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 an age-dependent escalation. However, preterm birth from the short-term outcomes and most of the long-term developmental outcomes, except for motor developmental delays 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% CI 1.24–1.82) and 1.54 (95% CI 1.17–2.03), respectively in the >44 years old group and 1.18 (95% confidence interval [CI], 1.11-1.25) and 1.19 (95% CI, 1.09-1.30) in the <25 years old group.
Conclusion
Overall, an advanced maternal age shows an age-dependent correlation with most congenital malformations, as well as short- and long-term outcomes of neonates. |
| Key Words:
Maternal age, Infant outcomes, Congenital abnormalities, Long-term outcomes, Preterm birth |
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