The Relationship Among Maternal Age,Risk Factors And Pregnancy Outcomes:A Retrospective Cohort Study

BackgroundIn recent years,advanced maternal age(?35 years old)is becoming increasingly higher year by year.This trend is linked to the socio-economic make-up of families as well as the change in the childbearing policy.A retrospective cohort study on maternal childbirth was conducted at Zhujiang Hospital from January 1,2015 to December 31,2017.Data on the effects of age associated adverse effects on pregnancy and pregnancy outcomes was then analyzed.This was then used to discuss the relationship between different incidences of pregnancy risk factors,delivery modes and neonatal adverse outcomes according to the years of implementation of the policy.Furthermore,to explore the statistical significance of the changes between different years and also the ages,then analyze the cause of the changes.Chapter 1 The relationship among maternal age,risk factors and pregnancy outcomesObjectiveThe aim of this paper is to discuss the relationship between the risk factors of gestational age and pregnancy outcomes.Additionally,to explore whether there are any differences between the different age groups,and discuss the causes of the risk factors.The purpose is aimed to ensure that the perinatal period is better guided with proper health-care and treatment and to improve the management and supervision of high-risk pregnancies.MethodsFrom the year 2015 to 2017,in Zhujiang Hospital,childbirth of all women was used,which comprised of 7016 births(n = 7016).Divided into 4 groups according to age(<24 years old,25-29 years old,30-34 years old,?35 years old).Data of 4 groups about pregnancy induced complications and outcomes were collected.Set group 20—29 years old group as the control group(O R =1).Use ?2 test and binary-logistic regression to analyze data.ResultsIn age>30 years old pregnant women,medical history of adverse pregnancy,the pregnancy which was assisted by reproductive technology,pregnancy with uterine fibroids,gestational diabetes,scar uterus,and thyroid dysfunction,the OR values were>1.And with the increase of age,OR values also increased.In the>35 years old groups,hydramnios,placenta previa,multiple pregnancy,postpartum hemorrhage and macrosomia delivery,low birth weight,premature,the OR values were>1.In the group of ?24 years old and ?35 years old,OR values of preeclampsia were>1.ConclusionAdvanced maternal age management has become an important task to the work of the perinatal health care provider.Compared with the nonsenile pregnant women;the incidences of chronic medical complications and pregnancy induced complications were higher in advanced women,so as the abnormal neonatal birth situations in the advanced age group.And the<24 years old group also has high risk of preeclampsia.Chapter 2 The changing situation about maternal age,risk factors and pregnancy outcomes after two-child policyObjectiveDiscuss the different incidences of pregnancy risk factors,delivery modes and neonatal adverse outcomes according to the years after the implementation of the two-child policy.To explore the statistical significance of the changes between different years and ages,and analyze the cause of the changes.MethodsAll 3 years from 2015 to 2017 were retrospectively analyzed in Zhujiang hospital,7016 cases of puerpera childbirth.According to the delivery time,the data were divided into three years,pregnant women ages were divided into four groups(the same as chapter one).Stratified chi-square was used to compare the incidences that may be affected by the age between different years,the pregnancy risk factors,childbirth modes and pregnancy outcomes.Which in the first chapter studies of the OR values were greater or less than 1,and P values were significant.ResultsAfter the childbearing policy changed,advanced maternal age ratio increased year by year.Between different years,different age groups,the incidence of the various risk factors,delivery mode and adverse pregnancy outcomes altered.Besides oligohydramnios,the differences of the risks in annual incidence had statistical significance.ConclusionDue to the changes in childbearing policy,age distribution proportion altered as well,especially advanced maternal proportion which rose year by year,and then caused the changes in the incidence of risk factors.The advancement of medical technology and society also affected the risk factors of pregnancy,delivery modes and pregnancy outcomes in different years.Clinical practitioners should therefore focus much more warranted attention and targeted inspection during the perinatal period based on the different age groups.Additionally,pay close attention to signs of maternal changes and timely intervention in high-risk pregnant women.Furthermore,enforce proper preventive and comprehensive treatment methods of any pregnancy associated complications,choosing the best delivery method,and then reducing the occurrence of neonatal anomalies to secure maternal women and infants' health comprehensively.