Advanced Maternal Age and

Perinatal Mortality
Fitrisia Rahma
030 08 105

INTRODUCTION
dvanced Maternal Age pregnancy after the age of 35

owadays, the number of women having a baby on the age of

35 and more is higher than before for a variety of reasons

he older women is more likely to request preconceptional

counseling

INTRODUCTION
A
fter age 35, women are at increased risk for obstetrical
complications as well as perinatal morbidity and mortality

O
lder women who have a chronic illness or are in poor physical
condition have more risks
A
dvanced maternal age was associated with a higher rate of
stillbirth

INTRODUCTION
erinatal mortality: period leading up to birth and the
first week of life largely due to obstetric causes

dvanced Maternal Age and Perinatal Mortality

More than one third of stillbirths take place during
delivery and are largely avoidable
The perinatal mortality rate is five times higher in
developing than in developed regions

MATERIAL AND METHOD

R
esearch design:
Cross-sectional study
Pulo Mas streets, East Jakarta
July 2011.

P
opulation and sample:
Women who had given birth to a child after and before the age of 35.

D
ata collection:
Data were collected through the questioner

MATERIAL AND METHOD

nclusion and exclusion criteria:
The women do not have illness during pregnancy (diabetes,
hypertension, eclampsia, preeclampsia, and infection)
The baby does not have twin, was not at abnormal position in
the uterus, and born without operational delivery

tatistical analysis
The women were categorized into two groups:
women who had given birth to a baby before 35 years old
women who had given birth to a baby on the age of 35 and more

MATERIAL AND METHOD

The statistical formula for Fishers exact test
was applied with the significant level set at
p0.05
The calculation was performed manually.

thical Clearance
Written consent was included

QUESTIONER
A

. Identity
Name
Age
Occupation

. Questions
In what age did you given birth to your baby/ies?
How many times have you given birth to before the age of 35 (dead or
alive)?
How many times have you given birth since the age of 35 (dead or
alive)?

QUESTIONER
How many babies have you given birth to since the
age of 35 (dead or alive)?
In what age did you deliver the baby/ies (after 35
y.o.)?
Child 1 was born when you were ___ years old
Child 2 was born when you were ___ years old
Etc.

*These questions under are related to Child 1

Was the baby born alive?

QUESTIONER
I

f the answer above is NO, did the baby die before or after they
were born?
A

re your children twins?

W

ere they at abnormal position in the uterus before the delivery?

W

ere they born normally or with operational delivery?

QUESTIONER
*These questions under are related to your condition when you
were having your Child 1
Do you have diabetes?
Do you have high blood pressure?
Did you have high blood pressure with proteinuria?
Did you have high blood pressure with proteinuria and seizure?
Did you have any infection?
(*Same questions for Child 2, etc.)

RESEARCH RESULT
f 34 women who participated in this study, 14 of
them were not analyzed because they did not
Variab
Perinatal
Born Alive
Total
fulfill
studyMortality
criteria
le
35
y.o.

10

< 35
y.o.

10

Total

14

20

Fishers Exact Test

2 =

d! h! n1! n0!
n! d1! h1! d0! h0!

P = 2 ( first value + smallest

value)

Table 1: 2=0,0054 Table 2: 2=0,0650

Table 3: 2=0,2438 Table 4: 2=0,3715

Table 5: 2=0,2438 Table 6: 2=0,0650

Table 5: 2=0,2438

tatistical Analysis
First value = 0,0650
Smallest value = 0,0054

= 2 ( first value + smallest value)

= 2 ( 0,0650 + 0,0054 )

= 0,1408

RESEARCH RESULT
tatistical analysis results p=0.1408

p>0.05) means There is no significant

association between advanced maternal age and
perinatal mortality

DISCUSSION
H
aving a baby in the age more than 35 increases the risk and complication
A
ffect the perinatal mortality
S
tatistical analysis shows that there is no significant association
A
dvanced maternal age is associated with higher rate of stillbirths
I
t has association with physiology of aging

DISCUSSION

D
ecreased myometrial efficiency occurs with aging cause
pregnancy complications including perinatal death
T
here are some risks of being pregnant in advanced age that
have to be taken care of

Good antenatal care and operative delivery might reduce the

risk

DISCUSSION
ocialize the effect of having a baby in advanced
maternal age

ocialize about proper antenatal care that they

should take to reduce the risks

References

M
arch of Dimes. Pregnancy After 35. Available at:
http://www.marchofdimes.com/trying_after35.html# . Accessed
on: May 29th 2011.

E
xpectant Mothers Guide to St. Louis. Schurk, MK. Advanced
Maternal Age, Pregnancy after Age 35. Available at:
http://www.expectantmothersguide.com/library/stlouis/ESLad
v_maternal_age.htm
. Accessed on: May 25th 2011.

References

unningham FG, et al. Williams Obstetrics 22th edition.

McGRAW-HILL Medical Publishing Division. 2005. P 194.

edscape News. Franz MB, Husslein PW. Obstetrical

Management of the Older Gravida: Stillbirth and Perinatal
Mortality. Available at:
http://www.medscape.com/viewarticle/721313_5. Accessed on:
June 23rd 2011.

References
orld Health Organization. Neonatal and Perinatal
Mortality Country, Regional, and Global
Estimates. 2006.

oldman JC, et al. Impact of Maternal Age on

Obstetric Outcome. 2005.