The trend in delayed childbearing and its potential consequences on pregnancy outcomes: a single center 9-years retrospective cohort study in Hubei, China.

ABSTRACT

BACKGROUND: Due to the advancement of modern societies, the proportion of women who delay childbearing until or beyond 30 years has dramatically increased in the last three decades and has been linked with adverse maternal-neonatal outcomes. OBJECTIVE: To determine the trend in delayed childbearing and its negative impact on pregnancy outcomes. MATERIAL AND METHODS: A tertiary hospital-based retrospective study was conducted in Wuhan University Renmin Hospital, Hubei Province, China, during the years 2011-2019. The joinpoint regression analysis was used to find a trend in the delayed childbearing and the multiple binary logistic regression model was used to estimate the association between maternal age and pregnancy outcomes. RESULTS: Between 2011 and 2019, the trend in advanced maternal age (AMA ≥35 years) increased by 75% [AAPC 7.5% (95% CI - 10.3, 28.9)]. Based on maternal education and occupation, trend in AMA increased by 130% [AAPC 11.8% (95% CI 1.1, 23.7)] in women of higher education level, and 112.5% [AAPC 10.1% (95% CI 9.4, 10.9)] in women of professional services. After adjusting for confounding factors, AMA was significantly associated with increased risk of gestational hypertension (aOR 1.5; 95% CI 1.2, 2.1), preeclampsia (aOR 1.6; 95% CI 1.4, 1.9), sever preeclampsia (aOR 1.7; 95% CI 1.1, 2.6), placenta previa (aOR 1.8; 95% CI 1.5, 2.2), gestational diabetes mellitus (aOR 2.5; 95% CI 2.3, 2.9), preterm births (aOR 1.6; 95% CI 1.4, 1.7), perinatal mortality (aOR 1.8; 95% CI 1.3, 2.3), and low birth weight (aOR 1.3; 95% CI 1.2, 1.4) compared with women aged < 30 years. CONCLUSION: Our findings show a marked increase in delayed childbearing and its negative association with pregnancy outcomes.