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Retrospective Cohort Study to Investigate Pregnancy Outcomes in a Population of advanced maternal age Congolese Women of Kinshasa: A Study Protocol

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Open Journal of Obstetrics and Gynecology 2024年第9期14卷 1398-1406页

作者： Anne Kapinga Mutshiaudi Thérèse Mikoka Walumpumpu Nicodem Nkutu Kimpu Joelle Lumaya Ambis Andy Mbangama Muela Roger Mbungu Mwimba Kahindo P. Muyalalo Department of Gynecology and Obstetrics Cliniques Universitaires de Kinshasa Kinshasa Congo Department of Basic Sciences Faculty of Medicine University of Kinshasa Kinshasa Congo

Introduction: Pregnancies at advanced maternal age (AMA) are those occurring after the age of 35 years old. They carry a high risk of maternal-fetal morbidity and mortality, thus constituting a public health problem. Several African countries have reported an upward trend in both the age of childbirth and the frequency of women with AMA over the past 20 years. In the Democratic Republic of Congo (DRC), where maternal and neonatal morbidity and mortality remain very high, data on AMA pregnancies go back more than 20 years. Objective: We propose evaluating obstetrical outcomes among women in AMA in our setting and the associated factors. Methods: This retrospective cohort study will be conducted in two healthcare facilities (ESS) in Kinshasa. The study population will consist of all women who delivered a single fetus after 28 weeks of gestation between January 2012 and December 2022 (10 years) in the selected ESS. The data collected will be analyzed using R software version 4.2.0. Quantitative variables will be summarized as means with standard deviation or medians with interquartile range. Qualitative variables will be presented as proportions (%). Multivariate logistic regression will be used to determine the main maternal-fetal complications associated with AMA and predictors of obstetric outcomes. P Discussion: The high maternal and infant mortality rates in DRC are among the highest in the world. The context of maternal age has become a topic of growing interest due to its potential implications for the health of women and newborns, it is crucial to identify the risk factors associated with obstetric outcomes by identifying obstetrical outcomes associated with advanced maternal age in the DRC. Many Congolese women tend to start their maternity journey at a relatively young age. However, there is also an emerging trend towards delayed childbearing, particularly in urban areas and among women with access to education and family planning services. Conclusion: The re

关键词： advanced maternal age Adverse maternal and Perinatal Outcome Congolese Women Kinshasa

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advanced maternal age and adverse obstetrical and neonatal outcomes of singleton pregnancies

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Gynecology and Obstetrics Clinical Medicine 2022年第4期2卷 175-180页

作者： Mitra Shekari Malihe Shirzadfardjahromi Amene Ranjbar Vahid Mehrnoush Fatemeh Darsareh Nasibeh Roozbeh Mother and Child Welfare Research Center Hormozgan University of Medical SciencesBandar AbbasIran Fertility and Infertility Research Center Hormozgan University of Medical SciencesBandar AbbasIran Urology Department Northern Ontario School of MedicineThunder BayOntarioCanada

Objective:To assess the impact of advanced maternal age on pregnancy and childbirth outcomes of singleton *** design:We retrospectively assessed singleton pregnant mothers who gave birth at Khaleej-e-Fars Hospital in Bandar Abbas,Iran,from January 2020 to January *** and obstetrical factors include educational level,medical insurance,residency place,access to prenatal care facilities,number of prenatal care visits,smoking status,gestational age,parity,infertility,maternal comorbidities,preeclampsia,eclampsia,preterm birth,low birth weight(LBW),intrauterine growth restriction(IUGR),macrosomia,placenta abnormalities(previa/acreta),placenta abruption,chorioamnionitis,meconium fluid,fetal distress,methods of delivery,rate of cesarean section(CS),perineal lacerations,postpartum hemorrhage,childbirth injury,shoulder dystocia,congenital malformation,neonatal asphyxia,and unfavorable maternal and neonatal outcome were compared between two *** Chi-square test assessed the relationship between categorical factors and maternal age *** influence of advanced maternal age on the risk of unfavorable pregnancy outcomes was evaluated using bivariate and multivariate logistic ***:Of 8354 singleton deliveries,22.2%belonged to advanced-age ***-age mothers had less education than those aged 20–34 years *** hypertension,cardiovascular disease,overt diabetes,and thyroid dysfunction were more prevalent among advanced-age *** with mothers aged 20–34 years,mothers aged 35 years and higher had a significantly higher risk of gestational diabetes(aOR:3.18,95%CI:1.56–6.95),preeclampsia(aOR:2.91,95%CI:1.35–4.72),placenta abnormalities(aOR:1.09,95%CI:0.77–1.94),CS(aOR:3.16,95%CI:1.51–3.87),postpartum hemorrhage(aOR:1.94,95%CI:1.24–2.61),intensive care unit admission(aOR:1.36,95%CI:1.15–1.99),LBW(aOR:1.35,95%CI:0.97–2.96),preterm birth(aOR:2.36,95%CI:1.65–4.83),stillbirth(aOR:1.18,95%CI:1.01–3.16),and neonatal

关键词： advanced maternal age Pregnancy Childbirth Perinatal outcome Neonatal outcomes

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Assisted Hatching in Couples with advanced maternal age： A Systematic Review and Meta-analysis

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Current Medical Science 2018年第3期38卷 552-557页

作者： Fan HE Chan-yu ZHANG Li-si WANG Sang-lin LI Li-na HU The Center for Reproductive Medicine Obstetrics and Gynecology Department the Second Affiliated Hospital ofChongqing Medical University Chongqing 400010 China

This systematic review aimed to evaluate the efficacy and safety of assisted hatching （AH） performed in couples with advanced maternal age. We searched for randomized controlled trials （RCTs） in electronic databases, including MEDLINE, EMBASE and CENTRAL （from inception to January 2018）; in addition, we hand-searched the reference lists of included studies and similar reviews. We included RCTs comparing AH versus no treatment （control）. The meta-analysis was performed by RevMan 5.3 software. The search retrieved 943 records and 8 RCTs were included, comprising 870 cycles （n=440 for AH, and n=430 for control）. There was no significant difference in the rates of live birth （RR 0.88, 95% CI 0.65 to 1.18, 3 RCTs, n-427,I^2=0%）, clinical pregnancy （RR 1.00, 95% CI 0.83 to 1.19, 8 RCTs, n=870, I^2=22%）, implantation （RR 1.07, 95% CI 0.83 to 1.39, 4 RCTs, n=1359, I^2=0%）, miscarriage （RR 1.13, 95% CI 0.66 to 1.94, 2 RCTs, n=116, I^2=0%） and multiple pregnancy （RR 0.89, 95% CI 0.31 to 2.52, 1 RCT, n=97,I^2=not applicable） between the treatment group and control group. No reasonable conclusions could be drawn regarding reproductive outcomes after AH in patients with advanced maternal age due to the small sample pooled in meta-analyses. Studies of high methodological quality and with adequate power are necessary to further investigate the value of AH in assisted conception of those patients.

关键词： assisted hatching advanced maternal age in vitro fertilization frozen-thawed embryo transfer

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Seizure frequency and obstetric complications at advanced maternal age:a preliminary observational study in women with epilepsy

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Acta Epileptologica 2021年第1期3卷 108-112页

作者： Hui Gao Nanya Hao Shanrui Liu Dong Zhou Department of Neurology West China HospitalSichuan UniversityChengdu 610041China Clinical Medicine West China School of MedicineSichuan UniversityChengdu 610041China

Background:Seizure control during pregnancy and obstetric outcomes are of important concerns for women with epilepsy(WWE)and their *** maternal age(≥35 years)shows a growing trend in the society with changes of lifestyle,which also occurs in diseased *** advanced maternal age is an independent factor for some unsatisfying obstetric *** this study we explored the seizure control and obstetric complications associated with advanced maternal age in ***:This study was based on the epilepsy pregnancy registry at West China *** with epilepsy in this registry who were aged 35 or older when starting pregnancy were included in this *** basic demographics and detailed information on epilepsy management and obstetric issues in all trimesters and during 1-year follow-up after birth were documented and *** were processed by IBM SPSS version *** demographic characteristics,seizure frequency,treatment change,obstetric complications,and outcomes were analyzed and ***:Fifteen patients were included in this study,with an average age of 36.32±2.39 years at pregnancy,and 73.33%of them were *** change of seizure frequency during pregnancy was not in a clear pattern,but there was an increased incidence of tonic-clonic seizures during the mid-and last *** than 20%of the patients had obstetric complications throughout the trimesters,including vaginal bleeding,hypothyroidism,and *** pre-eclampsia seemed extraordinarily complicated with other ***,none of the complications were related with malformations or poor outcome of babies after 1-year ***:advanced maternal age combined with WWE is associated with frequent common obstetric *** controlled studies with large sample sizes are needed to explore the related risks in comparison with other WWE and non-epileptic populations.

关键词： Women with epilepsy advanced maternal age Obstetric outcome Seizure control

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Obstetric Outcomes in advanced maternal age among Women at King Abdulaziz University Hospital

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Open Journal of Obstetrics and Gynecology 2023年第1期13卷 108-120页

作者： Rawan A. Gari Ghaday M. Alrefaei Shatha A. Alsuwaida Zahra M. Alalwan Zahraa H. Aljeshi Amenah H. Al Jumah Department of Obstetrics and Gynecology King Abdulaziz University Hospital Jeddah Saudi Arabia Faculty of medicine King Abdulaziz University Jeddah Saudi Arabia

Background: advanced maternal age, over 35 years, is a well-known risk factor for poor pregnancy outcomes. It is commonly associated with various pregnancy complications, such as spontaneous miscarriage, preeclampsia/ toxemia, gestational diabetes mellitus, preterm labor, stillbirth, chromosomal abnormalities, and cesarean delivery. Objectives: This study assessed obstetric and neonatal complications associated with advanced maternal age. Methods: We reviewed the medical records of 199 pregnant women over 35 years old at King Abdulaziz University Hospital in Jeddah, Saudi Arabia, from January to June 2022. We gathered data on age, nationality, number of antenatal visits, results of ultrasound scans for dating and viability, nuchal translucency and anatomy surveys, medications and multivitamins taken during pregnancy, smoking status, pregnancy, and fetal complications, and mode of delivery. Results: The prevalence of obstetric complications was 71.4% (preeclampsia/toxemia, 4.5%;antepartum hemorrhage, 4%;postpartum hemorrhage, 1%;and gestational diabetes, 23.1%). The most frequent complication was preterm labor between 34 and 36 weeks (48%), and only 12.6% of all deliveries were associated with fetal and neonatal complications such as congenital anomalies and neonatal jaundice. The prevalence of anemia during pregnancy was 10.1%, 21.1%, and 28.6% in the first, second, and third trimesters, respectively, and pregnancies complicated with antepartum or postpartum hemorrhage were associated with higher rates of anemia in the second trimester. A significant relationship was found between mean maternal age (38.84 ± 2.75 years) and the development of maternal complications (p age and anemia in the second trimester. Conclusion: Our findings confirm that pregnancy at an advanced maternal age is associated with increased overall maternal complications. T

关键词： advanced maternal age Preeclampsia/Toxemia Pregnancy Outcomes Com-plications KAUH Jeddah

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maternal Fetal Prognosis: Pregnancy and Delivery in Women of 40 Years Old and Over in a Second Reference Hospital in Bamako

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Open Journal of Obstetrics and Gynecology 2024年第4期14卷 509-519页

作者： Samaké Alou Diarra Lasseny Keita Mamadou Haidara Dramane Haidara Mamadou Diallo Mamadou Konaté Moussa Maiga Mariam Mohamed Saydi Ag Med Elmehdi Elansari Kassogue Djibril Seydou Zana Dao Samake Hawa Konate Karim Dembele Bertin Coulibaly Moussa Mariko Seydou Collarete Dohino Reference Health Center of Commune VI of the Bamako District Bamako Mali Bamako Dermatology Hospital (BDH) Bamako Mali Kalaban Coro Reference Health Center Bamako Mali Timbuktu Hospital Timbuktu Mali Reference Health Center of Commune II of the Bamako District Bamako Mali Reference Health Center in Commune V of the Bamako District Bamako Mali National Institute for Training in Health Sciences Bamako Mali Mali Hospital Bamako Mali

Introduction: Late pregnancies are considered a public health problem linked to maternal mortality due to their complications. These risks, which worsen with maternal age, should be better known and taken into account in monitoring these pregnancies. Objective: To evaluate the impact of age on the prevalence of obstetric and neonatal complications among parturients of 40 years old and over. Methodology: This was an 11-year retrospective analytical case control study from January 1, 2007 to December 31, 2017. The study population was female patients of 40 years old or older for cases and female patients younger than 40 years of control case. Results: In total, we collected 640 cases of parturients of 40 years old and over out of a total of 84,234 deliveries during the study period;i.e. a frequency of 0.76%. Spontaneous abortion increased in patients of 40 and over with 8.28%. Hypertension and diabetes were higher of women of 40 and over, 52.65%. Concerning the method of admission: 55% of parturients of 40 and over were referrals. Incidents occurring among women of 40 and over were more pronounced than in control cases. Complications during vaginal delivery, cervical tear, perineal tear, uterine dehiscence and uterine rupture are high in our cases, i.e. 11.88%;3.59%;2.19%;2.66. During our study, depending on the type of delivery, the cesarean rate was much higher among women of 40 and over than among control cases, i.e. 54.22% versus 12.24%. Hemorrhages in the 3rd trimester were the main indications for cesarean section. Hemorrhages in the 3rd trimester were more frequent with women of 40 and over, i.e. 10.47%;5.94% versus 1.74% and 0.42%. As for the different types of malformations in parturients, women under 40 years old fetal malformations were absent in 92.29%, on the other hand they were more frequent in patients with 40 years and over, i.e. a normal frequency of 36.72%. Conclusion: Pregnancy at a late age exposes the elderly patient and the newborn to several ri

关键词： advanced maternal age Childbirth Risk Mali

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Effect of maternal age on pregnancy： a retrospective cohort study

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Chinese Medical Journal 2014年第12期127卷 2241-2246页

作者： Liu Xiaoli Zhang Weiyuan Department of Obstetrics Beijing Obstetrics and Gynecology HospitalCapital Medical UniversityBeijing 100026China

Background In the last few decades,there has been a delay in first-time pregnancies,and the average age of women at the time of delivery has increased in many *** maternal age is associated with adverse pregnancy *** study aimed to determine the present trends and pregnancy outcomes related to maternal age in *** Data were collected from 39 hospitals in mainland of *** deliveries were performed after 28 completed weeks of gestation and between January 1 and December 31,*** total,110 450 of 112 441 cases were included in the *** enrolled cases were divided into 6 age groups with 5-year *** x2 test or Fisher＇s exact test and unadjusted binary-Logistic regression were used for statistical *** The mean age at the time of delivery was 28.18±4.70 years （range,14-52 years）.The teenage group （15-19 years） had a higher risk than the 25-29-year old group for anemia （odds ratio （OR）,1.4）,preeclampsia （OR,1.6）,preterm birth （OR,2.1）,low birth weight neonates （OR,2.3）,and perinatal mortality （OR,3.6）.The 35-39-year old group and ≥40-year-old group had a higher risk than the 25-29-year-old group for leiomyoma （OR,4.2 vs.5.8）,pregestational diabetes （OR,2.2 vs.3.8）,chronic hypertension （OR,4.6 vs.6.5）,gestational diabetes （OR,2.6 vs.3.5）,preeclampsia （OR,2.5 vs.3.6）,premature delivery （OR,1.8 vs.2.4）,postpartum hemorrhage （OR,1.5 vs.1.7）,placenta previa （OR,2.7 vs.4.0）,placental abruption （OR,1.4 vs.2.5）,cesarean delivery （OR,2.1 vs.2.5）,macrosomia （OR,1.2 vs.1.2）,low birth weight neonates （OR,1.6 vs.2.3）,and perinatal mortality （OR,1.6 vs.3.7）.Conclusion maternal and neonatal risks are higher during the teenage years and at an advanced maternal age; 20-30 years of age is the lowest risk period for pregnancy and delivery.

关键词： advanced maternal age teenage pregnancy maternal outcome neonatal outcome

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Epigenetic changes associated with oocyte aging

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Science China(Life Sciences) 2012年第8期55卷 670-676页

作者： SCHATTEN Heide MA JunYu SCHATTEN Heide SUN QingYuan State Key Laboratory of Reproductive Biology Institute of ZoologyChinese Academy of SciencesBeijing 100101China Department of Animal Sciences Chungbuk National UniversityCheongju 361-763 Republic of Korea Department of Veterinary Pathoiology Vniversity of MissouriColumbiaMO 65211USA

It is well established that the decline in female reproductive outcomes is related to postovulatory aging of oocytes and advanced maternal *** oocyte quality is correlated with compromised genetic integrity and epigenetic changes during the oocyte aging ***,we review the epigenetic alterations,mainly focused on DNA methylation,histone acetylation and methylation associated with postovulatory oocyte aging as well as advanced maternal ***,we address the underlying epigenetic mechanisms that contribute to the decline in oocyte quality during oocyte aging.

关键词： fertility advanced maternal age postovulatory oocyte aging DNA methylation histone modification

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Prediction of Cumulative Live Birth Rate in Women aged 40 Years and Over Undergoing In vitro Fertilization/Intracytoplasmic Sperm Injection

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Reproductive and Developmental Medicine 2020年第4期4卷 233-238页

作者： Jia Lei Chen Pan-Yu Guo Ying-Chun Zhang Zhi-Qiang Gong Xiao Chen Jing-Bo Fang Cong Reproductive Medicine Research Center Sixth Affiliated Hospital of Sun Yat-Sen UniversityTianhe DistrictGuangzhou 510275China Department of Epidemiology and Biostatistics School of Public HealthGuangdong Pharmaceutical UniversityGuangzhouChina

Objective:To investigate cumulative live birth rate (cLBR) per oocyte retrieval in infertile patients aged 40 years and over undergoing their first in vitro fertilization/intracytoplasmic sperm injection cycles and to identify the possible ***:A total of 1,613 patients at a university hospital in China from January 2013 to May 2017 were enrolled in this retrospective *** data for fresh and subsequent frozen-thawed cycles were *** logistic regression analysis with stepwise selection of possible predictors for cLBR was performed,and Loess curve was constructed to determine the association between cLBR and the number of oocytes ***:cLBR significantly increased with the number of oocytes retrieved and reached up to 75% when > 20 oocytes were retrieved (Paged 40 years and over,AFC and the number of oocytes retrieved were two key predictors for cLBR and maximization of ovarian reserve exploitation was pivotal to increase the chance of live birth.

关键词： advanced maternal age Cumulative Live Birth Rate In vitro Fertilization Number of Oocytes Retrieved

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A Pregnant Woman Died of Sudden Cardiac Death:Should Esophageal Foreign Body Be Considered an Inductive Factor?A Case Report and Literature Review

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Journal of Forensic Science and Medicine 2022年第4期8卷 186-189页

作者： Chang Cao Mingming Li Zhanzhan Liu Shiyong Fang Gang Chen Guang Chen Tongjun Ma Xuyang Zhu Xiang Xu School of Forensic Medicine Wannan Medical CollegeWuhuAnhui ProvinceChina Wannan Medical College Wuhu Zhiwei Pathology Diagnosis CenterWuhuAnhui ProvinceChina

Here,we report a case of acute attack of coronary heart disease(CHD).A 47‑year‑old pregnant woman with gestational hypertension developed sudden‑onset chest tightness,palpitations,dyspnea,and cyanosis of the face and lips after *** blood pressure was 180/110 mmHg and her blood oxygen saturation was 45%at that *** cardiopulmonary resuscitation,a weak heartbeat was restored,but oxygen saturation did not increase ***,she was transferred to the intensive care unit;however,she died after 21 days of *** findings revealed that a foreign body was embedded in the esophagus near the right piriform,and her heart weighed 392 g;histopathological examination revealed CHD,thrombosis in the lumen of the right coronary artery,cardiomyocyte hypertrophy,vascular hyaline degeneration in arterioles,neutrophils in the bronchiole and *** the tested samples yielded negative toxicological *** status and autopsy findings were not compatible with a diagnosis of peripartum *** patient’s sudden death was attributed to CHD,and esophageal foreign‑body impaction was considered to be concomitant *** findings might help in increasing the awareness between esophageal foreign‑body impaction and sudden cardiac death and they can also help in clarifying that understanding the primary cause of death is the key to resolving an iatrogenic medical tangle.

关键词： advanced maternal age coronary heart disease esophageal foreign body forensic pathology sudden cardiac death

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