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December 1, 1993, Vol 270, No. 21 >
ARTICLE | December 1, 1993

Maternal Age at First Childbirth and Risk of Low Birth Weight and Preterm Delivery in Washington State FREE

Michael B. Aldous, MD, MPH; M. Bruce Edmonson, MD, MPH
[+] Author Affiliations

Presented in part at the annual meeting of the Ambulatory Pediatrics Association, Baltimore, Md, May 5, 1992.

Reprint requests to the Department of Pediatrics, Arizona Health Sciences Center, Tucson, AZ 85724 (Dr Aldous).


JAMA. 1993;270(21):2574-2577. doi:10.1001/jama.1993.03510210060028
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References

Objective.  —To study the consequences of delayed first childbearing in a large, population-based US sample, with separate analysis of women aged 40 years or more and adjustment for socioeconomic factors, smoking, medical and reproductive conditions, and route of delivery.

Design and Setting.  —Retrospective survey of Washington State birth certificates from 1984 through 1988.

Subjects.  —First liveborn singleton infants of women aged at least 20 years. Of eligible white infants, all those born to women aged 35 to 39 years (n=4019) and 40 years or more (n=410) and a maternal age-stratified random sample of white infants of younger women were studied. All eligible black infants were studied.

Outcome Measures.  —Low (<2500 g) and very low (<1500 g) birth weight and preterm delivery (<37 weeks of gestation).

Results.  —Adjusted odds ratios for delivering a low-birth-weight white infant increased progressively with each 5-year maternal age group, reaching 2.3 (95% confidence interval, 1.6 to 3.4) for women aged 40 years or more compared with those aged 20 to 24 years. The maternal age effects for very low birth weight and preterm delivery were similar; for each, the odds ratio was 1.8 for the oldest group. No significant maternal age effect was found among births of black infants, but only 127 births to women aged 35 years or more were studied.

Conclusion.  —Increasing maternal age at first childbirth is an independent risk factor for low birth weight and preterm delivery of white infants in the United States.(JAMA. 1993;270:2574-2577)

REFERENCES

1 +
Ventura SJ.  Trends and variations in first births to older women, 1970-86. Vital Health Stat 21 .1989;; No. (47) .
2 +
Forman MR, Meirik O, Berendes HW.  Delayed childbearing in Sweden. JAMA . 1984;;252:3135-3139.
3 +
Israel SL, Deutschberger J.  Relation of the mother's age to obstetric performance. Obstet Gynecol . 1964;;24:411-417.
4 +
Friede A, Baldwin W, Rhodes PH, Buehler JW, Strauss LT.  Older maternal age and infant mortality in the United States. Obstet Gynecol . 1988;; 72:152-157.
5 +
Kane SH.  Advancing age and the primigravida. Obstet Gynecol . 1967;;29:409-414.
6 +
Morrison I.  The elderly primigravida. Am J Obstet Gynecol . 1975;;121:465-470.
7 +
Lee K-S, Ferguson RM, Corpuz M, Gartner LM.  Maternal age and incidence of low birth weight at term: a population study. Am J Obstet Gynecol . 1988;;158:84-89.
8 +
Berkowitz GS, Skovron ML, Lapinski RH, Berkowitz RL.  Delayed childbearing and the outcome of pregnancy. N Engl J Med . 1990;;322:659-664.
9 +
Grimes DA, Gross GK.  Pregnancy outcomes in black women aged 35 and older. Obstet Gynecol . 1981;;58:614-620.
10 +
Spellacy WN, Miller SJ, Winegar A.  Pregnancy after 40 years of age. Obstet Gynecol . 1986;;68:452-454.
11 +
Barkan SE, Bracken MB.  Delayed childbearing: no evidence for increased risk of low birth weight and preterm delivery. Am J Epidemiol . 1987;;125:101-109.
12 +
Ales KL, Druzin ML, Santini DL.  Impact of advanced maternal age on the outcome of pregnancy. Surg Gynecol Obstet . 1990;;171:209-216.
13 +
Kirz DS, Dorchester W, Freeman RK.  Advanced maternal age: the mature gravida. Am J Obstet Gynecol . 1985;;152:7-12.
14 +
Cnattingius S, Forman MR, Berendes HW, Isotalo L.  Delayed childbearing and risk of adverse perinatal outcome: a population-based study. JAMA . 1992;;268:886-890.
15 +
Berkowitz GS, Skovron ML, Lapinski RH, Berkowitz RL.  Does delayed childbearing increase risk? JAMA . 1993;;269:745-746.
16 +
Harrell FE.  The logist procedure.  In: Hastings RP, Joyner S, Whatley JK, Baggett DD, Hudnell MZ, eds. SUGI Supplemental Library User's Guide, Version 5 Edition . Cary, NC: SAS Institute Inc; 1986;:269-293.
17 +
Naeye RL.  Maternal age, obstetric complications, and the outcome of pregnancy. Obstet Gynecol . 1983;;61:210-216.
18 +
Stein ZA.  A woman's age: childbearing and child rearing. Am J Epidemiol . 1985;;121:327-342.
19 +
Eisner V, Brazie JV, Pratt MW, Hexter AC.  The risk of low birth weight. Am J Public Health . 1979;;69:887-893.
20 +
National Center for Health Statistics. Vital Statistics of the United States, 1988: Vol I—Natality . Washington, DC: US Government Printing Office; 1990;. US Dept of Health and Human Services publication PHS 90-1100.
21 +
Ventura SJ.  Advance report of new data from the 1989 birth certificate. Monthly Vital Stat Rep . 1992;;40(suppl to No. (12) ):1-32.
22 +
US Bureau of the Census. Statistical Abstract of the United States: 1992 . 112th ed. Washington, DC: US Government Printing Office; 1992;.
23 +
Cnattingius S, Forman MR, Berendes HW, Graubard BI, Isotalo L.  Effect of age, parity, and smoking on pregnancy outcome: a population-based study. Am J Obstet Gynecol . 1993;;168:16-21.
24 +
Montgomery TA, Lewis A, Hammes L.  Live birth certificates: evaluation of medical and health data in California. Calif Med . 1962;;96:190-195.
25 +
Frost F, Starzyk P, George S, McLaughlin JF.  Birth complication reporting: the effect of birth certificate design. Am J Public Health . 1984;;74: 505-506.
26 +
Harris MI, Hadden WC, Knowler WC, Bennett PH.  Prevalence of diabetes and impaired glucose tolerance and plasma glucose levels in US population aged 20-74 years. Diabetes . 1987;;36:523-534.
27 +
Young TK, Roos NP, Hammerstrand KM.  Estimated burden of diabetes mellitus in Manitoba according to health insurance claims: a pilot study. Can Med Assoc J . 1991;;144:318-324.
28 +
Geronimus AT, Andersen HF, Bound J.  Differences in hypertension prevalence among US black and white women of childbearing age. Public Health Rep . 1991;;106:393-399.
29 +
National Center for Health Statistics.  Advance report of final natality statistics, 1988. Monthly Vital Stat Rep . 1990;;39(suppl to No. (4) ):1-48.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Ventura SJ.  Trends and variations in first births to older women, 1970-86. Vital Health Stat 21 .1989;; No. (47) .
2 +
Forman MR, Meirik O, Berendes HW.  Delayed childbearing in Sweden. JAMA . 1984;;252:3135-3139.
3 +
Israel SL, Deutschberger J.  Relation of the mother's age to obstetric performance. Obstet Gynecol . 1964;;24:411-417.
4 +
Friede A, Baldwin W, Rhodes PH, Buehler JW, Strauss LT.  Older maternal age and infant mortality in the United States. Obstet Gynecol . 1988;; 72:152-157.
5 +
Kane SH.  Advancing age and the primigravida. Obstet Gynecol . 1967;;29:409-414.
6 +
Morrison I.  The elderly primigravida. Am J Obstet Gynecol . 1975;;121:465-470.
7 +
Lee K-S, Ferguson RM, Corpuz M, Gartner LM.  Maternal age and incidence of low birth weight at term: a population study. Am J Obstet Gynecol . 1988;;158:84-89.
8 +
Berkowitz GS, Skovron ML, Lapinski RH, Berkowitz RL.  Delayed childbearing and the outcome of pregnancy. N Engl J Med . 1990;;322:659-664.
9 +
Grimes DA, Gross GK.  Pregnancy outcomes in black women aged 35 and older. Obstet Gynecol . 1981;;58:614-620.
10 +
Spellacy WN, Miller SJ, Winegar A.  Pregnancy after 40 years of age. Obstet Gynecol . 1986;;68:452-454.
11 +
Barkan SE, Bracken MB.  Delayed childbearing: no evidence for increased risk of low birth weight and preterm delivery. Am J Epidemiol . 1987;;125:101-109.
12 +
Ales KL, Druzin ML, Santini DL.  Impact of advanced maternal age on the outcome of pregnancy. Surg Gynecol Obstet . 1990;;171:209-216.
13 +
Kirz DS, Dorchester W, Freeman RK.  Advanced maternal age: the mature gravida. Am J Obstet Gynecol . 1985;;152:7-12.
14 +
Cnattingius S, Forman MR, Berendes HW, Isotalo L.  Delayed childbearing and risk of adverse perinatal outcome: a population-based study. JAMA . 1992;;268:886-890.
15 +
Berkowitz GS, Skovron ML, Lapinski RH, Berkowitz RL.  Does delayed childbearing increase risk? JAMA . 1993;;269:745-746.
16 +
Harrell FE.  The logist procedure.  In: Hastings RP, Joyner S, Whatley JK, Baggett DD, Hudnell MZ, eds. SUGI Supplemental Library User's Guide, Version 5 Edition . Cary, NC: SAS Institute Inc; 1986;:269-293.
17 +
Naeye RL.  Maternal age, obstetric complications, and the outcome of pregnancy. Obstet Gynecol . 1983;;61:210-216.
18 +
Stein ZA.  A woman's age: childbearing and child rearing. Am J Epidemiol . 1985;;121:327-342.
19 +
Eisner V, Brazie JV, Pratt MW, Hexter AC.  The risk of low birth weight. Am J Public Health . 1979;;69:887-893.
20 +
National Center for Health Statistics. Vital Statistics of the United States, 1988: Vol I—Natality . Washington, DC: US Government Printing Office; 1990;. US Dept of Health and Human Services publication PHS 90-1100.
21 +
Ventura SJ.  Advance report of new data from the 1989 birth certificate. Monthly Vital Stat Rep . 1992;;40(suppl to No. (12) ):1-32.
22 +
US Bureau of the Census. Statistical Abstract of the United States: 1992 . 112th ed. Washington, DC: US Government Printing Office; 1992;.
23 +
Cnattingius S, Forman MR, Berendes HW, Graubard BI, Isotalo L.  Effect of age, parity, and smoking on pregnancy outcome: a population-based study. Am J Obstet Gynecol . 1993;;168:16-21.
24 +
Montgomery TA, Lewis A, Hammes L.  Live birth certificates: evaluation of medical and health data in California. Calif Med . 1962;;96:190-195.
25 +
Frost F, Starzyk P, George S, McLaughlin JF.  Birth complication reporting: the effect of birth certificate design. Am J Public Health . 1984;;74: 505-506.
26 +
Harris MI, Hadden WC, Knowler WC, Bennett PH.  Prevalence of diabetes and impaired glucose tolerance and plasma glucose levels in US population aged 20-74 years. Diabetes . 1987;;36:523-534.
27 +
Young TK, Roos NP, Hammerstrand KM.  Estimated burden of diabetes mellitus in Manitoba according to health insurance claims: a pilot study. Can Med Assoc J . 1991;;144:318-324.
28 +
Geronimus AT, Andersen HF, Bound J.  Differences in hypertension prevalence among US black and white women of childbearing age. Public Health Rep . 1991;;106:393-399.
29 +
National Center for Health Statistics.  Advance report of final natality statistics, 1988. Monthly Vital Stat Rep . 1990;;39(suppl to No. (4) ):1-48.

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