Maternal Age, Multiple Birth, and Extremely Low Birth Weight Infants
Received 27 June 2007; received in revised form 23 September 2008; accepted 29 October 2008. published online 29 December 2008.
Objectives
To compare the rates of adverse neurodevelopmental outcome or death at 18 to 22 months among extremely low birth weight (ELBW) infants born to mothers ≥40 years to the corresponding rates among infants of younger mothers.
Study design
Prospective evaluation of ELBW infants to quantify the relative risks of maternal age and multiple birth for death or adverse neurodevelopmental outcome.
Results
The sample consisted of 14 671 live ELBW births divided into maternal age groups: <20, 20 to 29, 30 to 39, and ≥40 years. Of infants born to mothers ≥40 years, 20% were multiples. Mothers ≥40 years had high rates of obstetric interventions and medical morbidities compared with mothers <40 years. ELBW live births of mothers ≥40 years were 22% more likely to survive and had a 13% decreased risk of neurodevelopmental impairment or death compared with mothers <20. Multiple birth, however, was associated with a 10% greater risk of neurodevelopmental impairment or death.
Conclusion
Although mothers ≥40 years had high pregnancy-related morbidities, we found no overall increased risk of the composite outcome of death or NDI. Multiple birth, however, was a predictor of all adverse outcomes examined, regardless of maternal age.
The National Institutes of Health and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) provided grant support (Appendix 2; available at www.jpeds.com) for the NICHD Neonatal Research Network's Generic Database Study (Recruitment: 1995-2003) and Follow-up Study. The funding agencies provided overall oversight for study conduct, but all data analyses and interpretation were independent of the funding agencies.
No reprints offered.
⁎ List of members of the NICHD Neonatal Research Network is available at www.jpeds.com (Appendix 1).
ABSTRACT