{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:07:37Z","timestamp":1778544457832,"version":"3.51.4"},"reference-count":8,"publisher":"Georg Thieme Verlag KG","funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["T32 HD007203-42"],"award-info":[{"award-number":["T32 HD007203-42"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>We aimed to investigate whether advanced maternal age is associated with cesarean delivery in nulliparous individuals undergoing elective induction of labor (eIOL).<\/jats:p>\n                  <jats:p>We queried a multicenter outpatient electronic medical record to perform a retrospective cohort study of nulliparous individuals undergoing eIOL between 390\/7 and 406\/7 weeks from January 2017 to June 2024. To investigate the relationship between age and eIOL, we created multiple study cohorts: (1) Age &lt;35 years, (2) age 35\u201339 years, and (3) age \u226540 years. We excluded pregnancies complicated by multifetal gestation, oligohydramnios, hypertensive disorders, diabetes requiring treatment, autoimmune disorders, or fetal growth restriction. The primary outcome was the rate of cesarean delivery, and secondary outcomes included indication for cesarean delivery and adverse maternal and neonatal outcomes.<\/jats:p>\n                  <jats:p>Of the 84,156 eligible individuals, 932 met our inclusion criteria, with 728 (78.1%), 141 (15.1%), and 63 (6.8%) with age &lt;35 years, 35\u201339 years, and \u226540 years, respectively. We found an increased incidence of cesarean delivery with increasing age (25.8% for age &lt;35 years, 41.1% for age 35\u201339 years, and 55.6% for age \u226540 years, p\u2009&lt;\u20090.01). After adjusting for confounders including pre-pregnancy body mass index (BMI), diet-controlled gestational diabetes, and in vitro fertilization, and using age &lt;35 years as the reference in a multivariable regression, this relationship remained consistent (age 35\u201339: adjusted odds ratio (OR)\u2009=\u20091.82 [95% confidence interval (CI): 1.14\u20132.91], and age \u226540: adjusted OR\u2009=\u20093.70 [95% CI: 1.90\u20137.22]). Aside from cesarean for arrest of dilation, there were no significant differences noted in the indications for cesarean delivery or other adverse outcomes.<\/jats:p>\n                  <jats:p>Our findings highlight an association between increasing maternal age and cesarean delivery among nulliparous individuals undergoing eIOL. Further studies should determine whether biologic or immunologic factors play a role or whether altered labor management may improve these outcomes.<\/jats:p>","DOI":"10.1055\/a-2864-0587","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T23:03:26Z","timestamp":1777417406000},"source":"Crossref","is-referenced-by-count":0,"title":["Maternal Age and Elective Inductions of Labor in Nulliparous Patients: A Multicenter Cohort Study"],"prefix":"10.1055","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2677-3023","authenticated-orcid":false,"given":"Minhazur","family":"Sarker","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, San Diego, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grace","family":"Noonan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, San Diego, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dana","family":"Canfield","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, San Diego, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Greg W.","family":"Poorman","sequence":"additional","affiliation":[{"name":"Dorsata, Inc. Arlington, Virginia, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara","family":"Levy","sequence":"additional","affiliation":[{"name":"Dorsata, Inc. Arlington, Virginia, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Edmundson","sequence":"additional","affiliation":[{"name":"Dorsata, Inc. Arlington, Virginia, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ukachi","family":"Emeruwa","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, San Diego, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cynthia","family":"Gyamfi-Bannerman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, San Diego, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leah","family":"Lamale-Smith","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, San Diego, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2026,5,11]]},"reference":[{"issue":"06","key":"ref1","first-page":"634","article-title":"Maternal age and adverse pregnancy outcome: a cohort study","volume":"42","author":"A Khalil","year":"2013","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"02","key":"ref2","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1503\/cmaj.070150","article-title":"Maternal age and risk of stillbirth: A systematic review","volume":"178","author":"L Huang","year":"2008","journal-title":"CMAJ"},{"issue":"06","key":"ref3","doi-asserted-by":"crossref","first-page":"1410","DOI":"10.1097\/01.AOG.0000163256.83313.36","article-title":"The perinatal effects of delayed childbearing","volume":"105","author":"K S Joseph","year":"2005","journal-title":"Obstet Gynecol"},{"issue":"06","key":"ref4","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1097\/MLR.0b013e3180330e26","article-title":"Induction of labor in the absence of standard medical indications: incidence and correlates","volume":"45","author":"M T Lydon-Rochelle","year":"2007","journal-title":"Med Care"},{"issue":"34","key":"ref5","doi-asserted-by":"crossref","first-page":"e27063","DOI":"10.1097\/MD.0000000000027063","article-title":"Effect of maternal age on maternal and perinatal outcomes including cesarean delivery following induction of labor in uncomplicated elderly primigravidae","volume":"100","author":"Y Jeong","year":"2021","journal-title":"Medicine (Baltimore)"},{"issue":"06","key":"ref6","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1056\/NEJMoa1800566","article-title":"Labor induction versus expectant management in low-risk nulliparous women","volume":"379","author":"W A Grobman","year":"2018","journal-title":"N Engl J Med"},{"issue":"07","key":"ref7","doi-asserted-by":"crossref","first-page":"1258","DOI":"10.1080\/14767058.2020.1745180","article-title":"Influence of maternal age in mode of delivery after term induction of labor","volume":"35","author":"G Kwayke-Ackah","year":"2022","journal-title":"J Matern Fetal Neonatal Med"},{"issue":"02","key":"ref8","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1016\/j.ejogrb.2012.02.016","article-title":"Induction of labour at term for women over 35 years old: A survey of the views of women and obstetricians","volume":"162","author":"K F Walker","year":"2012","journal-title":"Eur J Obstet Gynecol Reprod Biol"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2864-0587.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T23:07:36Z","timestamp":1778540856000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2864-0587"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,28]]},"references-count":8,"URL":"https:\/\/doi.org\/10.1055\/a-2864-0587","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"value":"0735-1631","type":"print"},{"value":"1098-8785","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,4,28]]},"published":{"date-parts":[[2026,4,28]]}}}