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Releases Saturday 24 June 2000
No 7251 Volume 320

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SUCCESSFUL PREGNANCY IS POOR IN OLDER
WOMEN, IRRESPECTIVE OF REPRODUCTIVE
HISTORY

(Paper: Maternal age and fetal loss: population based register
linkage study)
http://bmj.com/cgi/content/full/320/7251/1708

(Editorial: The risks of having children in later life)
http://bmj.com/cgi/content/full/320/7251/1681

The chance of a successful pregnancy declines considerably
in women aged more than 35 years, irrespective of her
reproductive history, according to new research in this
week's BMJ.

Danish researchers analysed the combined effects of maternal
age and reproductive history on outcome of pregnancy in
over 600,000 women between 1978 and 1992. They found
that more than one fifth of all pregnancies in 35 year old
women was unsuccessful - due to spontaneous abortion,
ectopic pregnancy or stillbirth - and at 42 years of age more
than half of the intended pregnancies was unsuccessful.

The risk of a spontaneous abortion varied from a minimum of
8% by the age of 22 years to over 84% by the age of 48
years or more, irrespective of previous reproductive
problems. Similarly, the risk of an ectopic pregnancy also
increased with increasing maternal age, from 1.4% of all
pregnancies at the age of 21 years to 6.9% in women aged
44 years or more. Interestingly, the risk of stillbirth was still
higher among women aged more than 35 years, but to a
lesser extent than for spontaneous abortion and ectopic
pregnancy.

These findings, say the authors, indicate that postponing
pregnancy will increase the level of unsuccessful pregnancies
and possibly the costs of health care. They conclude that
women should be counselled more fully to ensure that these
risks are taken into consideration when making decisions
about reproduction.

In an accompanying editorial, researchers at Columbia
University add that other aspects of reproduction, such as
multiple births and congenital malformations, should also be
considered by potential older parents yet are often beyond
the scope of routine records. However, on a positive note,
they suggest that a child born to older parents does have
advantages. For instance, their experience and knowledge
are bound to be greater than younger parents and their
economic situation better. "Biological disadvantage is to a
degree balanced by social advantage," they conclude.

Contacts:

[Paper] Anne-Marie Nybo Andersen, Research Fellow and
Mads Melbye, Professor of Epidemiology, Danish
Epidemiology Science Centre, Statens Serum Institut,
DK-2300, Copenhagen S, Denmark
Email: any{at}ssi.dk or mme{at}ssi.dk

[Editorial] Zena Stein and Mervyn Susser, Emeritus
Professors, Joseph L Mailman School of Public Health,
Columbia University, 600W 168th Street, PH18, New York,
10032, USA
Email: zas2{at}columbia.edu or mws2{at}columbia.edu

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