The New England Journal of Medicine
e-mail icon  FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |    Advanced Search
Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe
 
Original Article
Volume 333:953-957 October 12, 1995 Number 15
NextNext

Increased Maternal Age and the Risk of Fetal Death
Ruth C. Fretts, M.D., M.P.H., Julie Schmittdiel, M.A., Frances H. McLean, B.Sc.N., Robert H. Usher, M.D., and Marlene B. Goldman, Sc.D.

 Sign up for free e-toc
 

This Article
-Full Text
- PDF

Tools and Services
-Add to Personal Archive
-Add to Citation Manager
-Notify a Friend
-E-mail When Cited

More Information
-PubMed Citation
ABSTRACT

Background Although the fetal death rate has declined over the past 30 years among women of all ages, it is unknown whether particular characteristics of the mother, such as age, still affect the risk of fetal death. We undertook a study to determine whether older age, having a first child (nulliparity), or other characteristics of the mother are risk factors for fetal death.

Methods We used data from the McGill Obstetrical Neonatal Database to evaluate risk factors for fetal death among all deliveries at the Royal Victoria Hospital in Montreal (n = 94,346) from 1961 through 1993. Data were available for two time periods (1961 through 1974 and 1978 through 1993); data for 1975 through 1977 have not been entered into the data base and were therefore not included. Using logistic regression, we estimated the effect of specific maternal characteristics and complications of pregnancy on the risk of fetal death.

Results The fetal death rate decreased significantly from 11.5 per 1000 total births (including live births and stillbirths) in the 1960s to 3.2 per 1000 in 1990 through 1993 (P<0.001). Between these periods, the average maternal age at delivery increased from 27 to 30 years (P<0.001), and the frequency of the diagnosis of diabetes and hypertension during pregnancy increased fivefold (P<0.001). Nevertheless, after we controlled for these and other maternal characteristics, women 35 years of age or older continued to have a significantly higher rate of fetal death than their younger counterparts (odds ratio for women 35 to 39 years of age as compared with women <30 years of age, 1.9; 95 percent confidence interval, 1.3 to 2.7; for those 40 or older, 2.4; 95 percent confidence interval, 1.3 to 4.5).

Conclusions Changes in maternal health and obstetrical practice have resulted in a 70 percent decline in the rate of fetal death among pregnant women of all ages since the 1960s. Advancing maternal age, however, continues to be a risk factor for fetal death.


Source Information

From the Department of Obstetrics and Gynecology, Beth Israel Hospital and Harvard Medical School, Boston (R.C.F.); the Department of Epidemiology, Harvard School of Public Health, Boston (J.S., M.B.G.); and the Department of Obstetrics and Gynecology, Royal Victoria Hospital and McGill University, Montreal (F.H.M., R.H.U.).

Address reprint requests to Dr. Fretts at the Department of Obstetrics and Gynecology, Beth Israel Hospital, 330 Brookline Ave., Boston, MA 02215.

Full Text of this Article


This article has been cited by other articles:



HOME  |  SUBSCRIBE  |  SEARCH  |  CURRENT ISSUE  |  PAST ISSUES  |  COLLECTIONS  |  PRIVACY  |  TERMS OF USE  |  HELP  |  beta.nejm.org

Comments and questions? Please contact us.

The New England Journal of Medicine is owned, published, and copyrighted © 2009 Massachusetts Medical Society. All rights reserved.