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      Resultados perinatais nos extremos da vida reprodutiva e fatores associados ao baixo peso ao nascer Translated title: Perinatal outcomes in the extremes of reproductive age and factors associated with low weight at birth Translated title: Resultados perinatales en los extremos de la vida reproductiva y factores asociados al bajo peso al nacer

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          Abstract

          Objetivou-se investigar os resultados perinatais nos extremos da vida reprodutiva e verificar os fatores de risco para o baixo peso ao nascer. Trata-se de um estudo retrospectivo dos partos ocorridos no município de Sarandi, Paraná, no ano de 2008, a partir de consultas aos dados do Sistema de Informação de Nascidos Vivos. As 331 gestantes foram subdivididas em dois grupos: adolescentes (10-19 anos) e tardias (35 anos ou mais). As taxas de parto cesáreo foram significativamente maiores (66,1%) nas gestantes com 35 anos ou mais do que nas adolescentes (26,8%). Quanto aos fatores de risco para o baixo peso ao nascer, observou-se que este esteve fortemente associado com prematuridade e o estado civil. Os resultados perinatais das gestantes com 35 anos ou mais não apresentaram diferença significativa quando comparados aos resultados das adolescentes, confirmando a ocorrência de resultados adversos nos dois extremos da vida reprodutiva, exceto pela ocorrência de parto cesáreo.

          Translated abstract

          The objective was to investigate perinatal outcomes in the extremes of reproductive age and verify the risk factors for low birth weight. This is a retrospective study was performed of deliveries in the city of Sarandi, state of Paraná, Brazil, in 2008, by accessing data from the Information System on Live Births. The 331 expectant mothers were subdivided into two groups: adolescents (10-19 years of age) and late-age mothers (35 years or older). Rates of cesarean deliveries were significantly higher (66.1%) in mothers 35 or older than in adolescents (26.8%). Regarding risk factors for low weight at birth, it was observed that this condition was strongly associated with prematurity and marital status. The perinatal outcomes of mothers 35 or older were not significantly different when compared to the results of the adolescents, confirming the occurrence of adverse results in both extremes of reproductive age, except for the incidence of cesarean delivery.

          Translated abstract

          El objetivo fue investigar los resultados perinatales en los extremos de la vida reproductiva y verificar los factores de riesgo de bajo peso al nacer. Se trata de un estudio retrospectivo de partos ocurridos en Municipio de Sarandi, Paraná, Brasil, en año de 2008, a partir de consultas a datos del Sistema de Información de Nacidos Vivos. Las 331 embarazadas se dividieron en dos grupos: adolescentes (10-19 años) y tardías (35 años o más). Las tasas de parto cesáreo fue significativamente mayor (66,1%) en embarazadas con 35 años o más de que en los adolescentes (26,8%). En cuanto los factores de riesgo de bajo peso al nacer, se observó que éste estuvo fuertemente asociado con prematuras y estado civil. Los resultados perinatales de embarazadas con 35 años o más no presentaron diferencia significativa en comparación con los resultados de los adolescentes, lo que confirma lo aparición de resultados adversos en los extremos da vida reproductiva, excepto por ocurrencia de parto cesáreo.

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          Most cited references20

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          Teenage pregnancy and adverse birth outcomes: a large population based retrospective cohort study.

          Whether the association between teenage pregnancy and adverse birth outcomes could be explained by deleterious social environment, inadequate prenatal care, or biological immaturity remains controversial. The objective of this study was to determine whether teenage pregnancy is associated with increased adverse birth outcomes independent of known confounding factors. We carried out a retrospective cohort study of 3,886,364 nulliparous pregnant women <25 years of age with a live singleton birth during 1995 and 2000 in the United States. All teenage groups were associated with increased risks for pre-term delivery, low birth weight and neonatal mortality. Infants born to teenage mothers aged 17 or younger had a higher risk for low Apgar score at 5 min. Further adjustment for weight gain during pregnancy did not change the observed association. Restricting the analysis to white married mothers with age-appropriate education level, adequate prenatal care, without smoking and alcohol use during pregnancy yielded similar results. Teenage pregnancy increases the risk of adverse birth outcomes that is independent of important known confounders. This finding challenges the accepted opinion that adverse birth outcome associated with teenage pregnancy is attributable to low socioeconomic status, inadequate prenatal care and inadequate weight gain during pregnancy.
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            Impact of maternal age on obstetric outcome.

            To estimate the effect of maternal age on obstetric outcomes. A prospective database from a multicenter investigation of singletons, the FASTER trial, was studied. Subjects were divided into 3 age groups: 1) less than 35 years, 2) 35-39 years, and 3) 40 years and older. Multivariable logistic regression analysis was used to assess the effect of age on outcomes after adjusting for race, parity, body mass index, education, marital status, smoking, medical history, use of assisted conception, and patient's study site. A total of 36,056 women with complete data were available: 28,398 (79%) less than 35 years of age; 6,294 (17%) 35-39 years; and 1,364 (4%) 40 years and older. Increasing age was significantly associated with miscarriage (adjusted odds ratio [adjOR]2.0 and 2.4 for ages 35-39 years and age 40 years and older, respectively), chromosomal abnormalities (adjOR 4.0 and 9.9), congenital anomalies (adjOR 1.4 and 1.7), gestational diabetes (adjOR 1.8 and 2.4), placenta previa (adjOR 1.8 and 2.8), and cesarean delivery (adjOR 1.6 and 2.0). Patients aged 35-39 years were at increased risk for macrosomia (adjOR 1.4). Increased risk for abruption (adjOR 2.3), preterm delivery (adjOR 1.4), low birth weight (adjOR 1.6), and perinatal mortality (adjOR 2.2) was noted in women aged 40 years and older. Increasing maternal age is independently associated with specific adverse pregnancy outcomes. Increasing age is a continuum rather than a threshold effect.
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              The risks associated with pregnancy in women aged 35 years or older.

              The obstetric risks of adverse outcome during pregnancy in women aged > or =35 years were quantified using a retrospective analysis of data from 385 120 singleton pregnancies in the North West Thames Region, UK, between 1988 and 1997. A comparison of pregnancy outcome was made on the basis of maternal age at delivery: 18-34 years (n = 336 462), 35-40 years (n = 41 327) and women aged > 40 years (n = 7331). Women aged 40 year old women, with adjusted odds ratios (OR) according to age group. Pregnant women aged 35-40 years were at increased risk of: gestational diabetes, OR = 2.63 [99% confidence interval (CI) 2.40-2.89]; placenta praevia = 1.93 (1.58-2.35); breech presentation = 1.37 (1.28-1.47); operative vaginal delivery = 1.5 (1.43-1.57); elective Caesarean section = 1.77 (1.68-1.87); emergency Caesarean section = 1.59 (1.52-1.67); postpartum haemorrhage = 1.14 (1.09-1.19); delivery before 32 weeks gestation = 1.41 (1.24-1.61); birthweight below the 5th centile = 1.28 (1.20-1. 36); and stillbirth = 1.41 (1.17-1.70). Women aged >40 years had higher OR for the same risks. Pregnant women aged >/=35 years are at increased risk of complications in pregnancy compared with younger women.
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                Author and article information

                Journal
                rgenf
                Revista Gaúcha de Enfermagem
                Rev. Gaúcha Enferm.
                Universidade Federal do Rio Grande do Sul. Escola de Enfermagem (Porto Alegre, RS, Brazil )
                0102-6933
                1983-1447
                June 2011
                : 32
                : 2
                : 362-368
                Affiliations
                [01] Maringá Paraná orgnameUEM orgdiv1Departamento de Enfermagem Brasil
                Article
                S1983-14472011000200020 S1983-1447(11)03200220
                10.1590/S1983-14472011000200020
                0ef1e181-0c45-419e-b109-35454bf764a2

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 02 July 2010
                : 19 November 2010
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 19, Pages: 7
                Product

                SciELO Revista de Enfermagem

                Categories
                Artigos Originais

                Maternal age,Fatores de risco,Peso ao nascer,Resultado da gravidez,Idade materna,Factores de riesgo,Peso al nacer,Resultado del embarazo,Edad materna,Risk factors,Birth weight,Pregnancy outcome

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