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Epidemiology and policy
P1-194 Health implications of ageing motherhood
  1. R Klemetti,
  2. M Gissler,
  3. E Hemminki
  1. National Institute for Health and Welfare, Helsinki, Finland

Abstract

Introduction In developed countries, postponing of childbearing has become common, but health impacts are poorly known.

Methods All first births in Finland in 2008 (n=23 511) from nationwide medical birth register were included. Older mothers (35–39 and 40 years and over) were compared to younger mothers aged 20–34 years. Perinatal outcomes were adjusted for mother's background characteristics (marital status, socioeconomic position, smoking, previous pregnancies, and urbanity of the residence) by logistic regression. Births in years 2005–2009 were pooled to identify threshold age(s) for increased problems.

Results Older mothers used more antenatal care, had more chronic and pregnancy-related diseases, higher BMI, and more interventions. The adjusted ORs (95% CI) for 35–39 years old were: birth weight <1500 g 1.76 (1.23–2.53), birth weight <2500 g 1.67 (1.41–1.97), respiratory treatment 1.50 (1.07–2.11), and special care 1.21 (1.07–1.37). Among mothers aged 40 years or more preterm birth (<37 gw) 1.45 (1.04–2.02), birth weight <2500 g 1.59 (1.14–2.23), special care (1.64, 1.31–2.07), and perinatal mortality (2.69, 1.07–6.78) were more common. No clear threshold ages were found. Some problems increased steadily since age 20 years (cesarean section), slightly since age 30–34 years (many antenatal visits, hospitalisation, induction of labour, long postpartum stay, preterm birth, low birth weight, infant care in special unit), or rapidly since age 31–34 years (gestational diabetes and hypertension).

Conclusion Older mothers have more pregnancy and delivery problems, and higher risk for poorer infant outcomes. Most problems increased since early 30s. More detailed analysis of threshold ages for problems will be made.

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