Abstract
Objective The study aimed to determine the outcome of babies born to women ≥40 years in a Jamaican
birth cohort.
Study Design Maternal demographic data and neonatal data for women ≥40 years who delivered live
singleton babies and their younger counterparts aged 20 30 years were extracted from
the JA KIDS birth cohort dataset. Outcome measures were preterm birth, low birth weight,
very low birth weight, extremely low birth weight, macrosomia, a low 5-minute Apgar
score <7, admission to the neonatal unit, and neonatal death. Descriptive analyses
were performed; statistical significance was taken at the level p <0.05.
Results A total of 5,424 women and their babies were entered into the study, 5,099 (94%)
women were aged 20 to 30 years (mean age ± standard deviation [SD]: 24.5 ± 3.2 years)
and 325 (6%) were aged ≥40 years (mean age ± SD: 41.5 ± 1.6 years). A greater percentage
of preterm babies (18%) were born to women ≥40 years than to their younger counterparts
(14%; p = 0.04). There was no difference in the proportion of low birth weight infants, very
low birth weight infants, or extremely low birth weight infants born between the two
groups (p > 0.05). There was also no significant difference in the proportion of babies who
were macrosomic and in those who had a low 5-minute Apgar score <7. There were 866
(16%) neonatal admissions, 67/325 (21%) of these babies were born to women aged ≥40
years and 799/5,099 (16%) were born to their younger counterparts (p = 0.01). The commonest reason for admission was prematurity. While 60 babies died,
there was no significant difference between both groups with 56 (1%) born to women
20 to 30 years and 4 (1%) born to women ≥40 years (p = 0.48).
Conclusion Adverse outcomes noted for babies born to women ≥40 years were prematurity and the
need for neonatal admission. However, no excess mortality was recorded.
Key Points
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Women 40 years and older are more likely to have a chronic illness such as hypertension
and diabetes and to have an operative delivery.
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Babies born to women 40 years and older are more likely to be late premature infants
and require neonatal admission.
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However, there is no increased risk of neonatal mortality.
Keywords
advanced maternal age - neonatal outcome - low and middle income countries
