Schwangerschaften bei erhöhtem mütterlichen Alter: Ergebnisse aus Zürich und Literaturübersicht

Advanced maternal age compared to younger maternal age is associated with a steep increase in complications during early pregnancy, fetal aneuploidy and spontaneous early abortion. Similarly, second and third trimester complications including multiple pregnancies, intrauterine growth restriction, intrauterine death, placenta praevia, placental abruption, premature preterm rupture of membranes and preterm labor are increased. Interestingly, premature delivery and perinatal mortality - the most important parameters for the description of overall fetal pregnancy risk - are only modestly increased, if maternal age is controlled for preexisting maternal complications such as diabetes mellitus type 2, arterial hypertension and arteriosclerosis by statistical methods and if multiple pregnancies are excluded. Advanced maternal age is a pregnancy risk factor and adequate counselling is mandatory, but the prognosis of singleton pregnancies is similar to that of younger pregnant women, if there are no preexisting maternal diseases. However, due to the high incidence of fetal aneuploidy and spontaneous early abortion with advanced maternal age, postponing pregnancy after the age of 40 is associated with a high failure rate and therefore is not recommended.