{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T20:23:32Z","timestamp":1783023812312,"version":"3.54.6"},"reference-count":39,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T00:00:00Z","timestamp":1776816000000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Pregnancy at advanced maternal age is increasing globally, yet risks related to hypertensive disorders, prematurity, and impaired fetal growth remain substantial, particularly in tertiary\u2010care settings. This study aimed to quantify maternal and neonatal complications among women aged \u2265\u200935 years delivering in tertiary hospitals in Dhaka, Bangladesh, and to examine factors associated with adverse maternal and neonatal outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted an analytical cross\u2010sectional study at discharge in two tertiary referral hospitals. Consecutive eligible women aged \u2265\u200935 years were enrolled (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009384). Primary outcomes were binary composites of any maternal adverse outcome and any neonatal adverse outcome. Associations were examined using Pearson's\n                      <jats:italic>\u03c7<\/jats:italic>\n                      \u00b2 tests, and adjusted odds ratios (AORs) with 95% confidence intervals were estimated using Firth penalized logistic regression to address sparse data.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Maternal adverse outcomes occurred in 97.7% of women, most commonly preeclampsia (27.3%), premature rupture of membranes (26.0%), and oligohydramnios (23.2%). Neonatal adverse outcomes affected 80.5% of births, dominated by prematurity (72.9%), preterm delivery (74.0%), and low birthweight (52.3%). Very\u2010low birthweight was markedly more frequent among infants of mothers aged \u2265\u200940 years than 35\u201339 years (51.9% vs. 7.6%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). In adjusted analyses, no factors remained independently associated with maternal adverse outcomes. For neonatal outcomes, normal birthweight was strongly protective compared with very\u2010low birthweight (AOR 0.03, 95% CI 0.01\u20130.35), while grand multiparity was associated with lower odds compared with primiparity (AOR 0.04, 95% CI 0.00\u20130.86).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this tertiary referral context, maternal complications were nearly universal, while neonatal risk was strongly structured by birthweight. These findings support age\u2010attuned antenatal surveillance and preparedness for small\u2010baby care among women of advanced maternal age.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.72424","type":"journal-article","created":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T05:19:13Z","timestamp":1776921553000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Adverse Maternal and Neonatal Outcomes Among Women of Advanced Maternal Age in a Tertiary\u2010Care Setting in Bangladesh: A Cross\u2010Sectional Study"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-8872-1920","authenticated-orcid":false,"given":"Humayra Afroz","family":"Pinky","sequence":"first","affiliation":[{"name":"Department of Public Health North South University Dhaka Bangladesh"},{"name":"Projahnmo Research Foundation Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6883-0284","authenticated-orcid":false,"given":"MD Nahid Hassan","family":"Nishan","sequence":"additional","affiliation":[{"name":"Department of Public Health North South University Dhaka Bangladesh"},{"name":"Projahnmo Research Foundation Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1343-0144","authenticated-orcid":false,"given":"Gazi Md. Ehsanul","family":"Alam","sequence":"additional","affiliation":[{"name":"Projahnmo Research Foundation Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,22]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajhb.70037"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmad028"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10680-012-9277-y"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/jmwh.13759"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10834-020-09742-4"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2013.00009"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.3389\/fgwh.2022.989020"},{"key":"e_1_2_13_9_1","unstructured":"\u201cPreterm Birth \u201d accessed September 2025 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