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Impacto da idade materna avançada nos desfechos obstétricos e perinatais
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A gestação em idade materna avançada (IMA) é, a nível mundial, uma realidade cada vez mais frequente na prática obstétrica. Contudo, não existe consenso na literatura quanto às suas potenciais implicações, quer para a mãe, quer para o feto e recém-nascido. Este estudo tem por objetivo comparar os desfechos obstétricos e perinatais em grávidas abaixo e acima dos 35 anos de idade, nos últimos 4 anos, no Centro Hospitalar Universitário Lisboa Norte/Hospital de Santa Maria (CHULN/HSM). Tratou-se de um estudo observacional retrospectivo, baseado na consulta de registos clínicos do programa ObsCare que incluiu 5000 gestações, as quais foram divididas em três grupos de acordo com a idade materna no momento do parto: 18-34 anos, 35-39 anos e ≥40 anos. A análise estatística foi realizada no software IBM SPSS Statistics 29, utlizando o Teste do Qui-quadrado de Homogeneidade de Pearson e Regressão Logística Binária Multivariável. Foram considerados significativos, valores de p < 0.05. Os resultados obtidos, após controlo para possíveis fatores de confundimento, revelaram que existe uma associação significativa entre a IMA e a ocorrência de diabetes gestacional, de hipertensão gestacional, de cromossomopatia, de morte fetal, de cesariana e de malformações congénitas. Em conclusão, com vista a tentar controlar e minimizar os riscos maternos e perinatais acrescidos (diabetes gestacional, hipertensão gestacional, cromossomopatia, morte fetal, cesariana e malformações congénitas), é essencial que haja uma vigilância reforçada da gravidez em mulheres com IMA.
Pregnancy in advanced maternal age (AMA) is becoming increasingly common in obstetric practice worldwide. However, there is no consensus in the literature regarding its potential implications for both the mother and the fetus/newborn. This study aims to compare obstetric and perinatal outcomes between pregnant women below and above 35 years of age over the past 4 years at the Centro Hospitalar Universitário Lisboa Norte/Hospital de Santa Maria (CHULN/HSM). It was a retrospective observational study based on the review of clinical records from the ObsCare program, which included 5000 pregnancies. The pregnancies were divided into three groups based on maternal age at the time of delivery: 18-34 years, 35-39 years, and ≥40 years. Statistical analysis was performed using IBM SPSS Statistics 29, using Pearson's Chi-squared test for homogeneity and multivariable binary logistic regression. A significance level of p<0.05 was considered. The results, after controlling for possible confounding factors, revealed a significant association between AMA and the occurrence of gestational diabetes, gestational hypertension, chromosomal abnormalities, fetal death, cesarean delivery, and congenital malformations. In conclusion, in order to control and minimize the increased maternal and perinatal risks associated with AMA (gestational diabetes, gestational hypertension, chromosomal abnormalities, fetal death, cesarean delivery, and congenital malformations), enhanced surveillance of pregnancy is essential for women of advanced maternal age.
Pregnancy in advanced maternal age (AMA) is becoming increasingly common in obstetric practice worldwide. However, there is no consensus in the literature regarding its potential implications for both the mother and the fetus/newborn. This study aims to compare obstetric and perinatal outcomes between pregnant women below and above 35 years of age over the past 4 years at the Centro Hospitalar Universitário Lisboa Norte/Hospital de Santa Maria (CHULN/HSM). It was a retrospective observational study based on the review of clinical records from the ObsCare program, which included 5000 pregnancies. The pregnancies were divided into three groups based on maternal age at the time of delivery: 18-34 years, 35-39 years, and ≥40 years. Statistical analysis was performed using IBM SPSS Statistics 29, using Pearson's Chi-squared test for homogeneity and multivariable binary logistic regression. A significance level of p<0.05 was considered. The results, after controlling for possible confounding factors, revealed a significant association between AMA and the occurrence of gestational diabetes, gestational hypertension, chromosomal abnormalities, fetal death, cesarean delivery, and congenital malformations. In conclusion, in order to control and minimize the increased maternal and perinatal risks associated with AMA (gestational diabetes, gestational hypertension, chromosomal abnormalities, fetal death, cesarean delivery, and congenital malformations), enhanced surveillance of pregnancy is essential for women of advanced maternal age.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2023
Palavras-chave
Idade materna avançada Desfechos obstétricos Desfechos perinatais Obstetrícia