{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T22:54:27Z","timestamp":1778540067968,"version":"3.51.4"},"reference-count":35,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2018,11,1]],"date-time":"2018-11-01T00:00:00Z","timestamp":1541030400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Women's Health"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The purpose of this study was to evaluate the maternal outcome in women with very advanced maternal age (VAMA) at childbirth (&gt;45 years) compared to advanced maternal age (35\u201339 and 40\u201344 years).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Retrospective cohort study using the Texas Public Use Data File, years 2013\u20132014. Maternal age was a three-level variable: 35\u201339 (referent), 40\u201344, and 45\u201359 years (VAMA). Adjusted risk ratios (aRRs) for the two older age groups for various obstetrical and nonobstetrical complications were calculated from log-binomial regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The sample consisted of 96,879 deliveries. In univariate analyses, a higher frequency (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.05) of gestational diabetes, pregestational diabetes, chronic hypertension, pregnancy related hypertensive disorders, multiple gestation, oligohydramnios, polyhydramnios, placenta previa, postpartum hemorrhage, small for gestational age, intrauterine fetal death, and length of stay were noted in the two older maternal age groups compared to the youngest maternal age group. Multiple gestations were noted to be more frequent in the two older groups: the VAMA group had a 336% increase in their risk (aRR\u2009=\u20094.36, 95% CI: 3.68\u20135.17), while women 40\u201344 years of age experienced a 17% increase in their risk (aRR\u2009=\u20091.17, 95% CI: 1.07\u20131.29) compared to women in the 35\u201339 year group. The risk of the following outcomes was approximately doubled in VAMA women compared to the referent (all statistically significant): small for gestational age (aRR\u2009=\u20091.92), stillbirth (aRR\u2009=\u20092.12), and intrauterine fetal death (aRR\u2009=\u20091.96).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>This population-based study detected a dose\u2013response association between maternal age and the risk of multiple maternal and fetal complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/jwh.2018.7027","type":"journal-article","created":{"date-parts":[[2018,7,18]],"date-time":"2018-07-18T08:11:09Z","timestamp":1531901469000},"page":"1378-1384","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":36,"title":["Outcomes of Women Delivering at Very Advanced Maternal Age"],"prefix":"10.1177","volume":"27","author":[{"given":"Sushila","family":"Arya","sequence":"first","affiliation":[{"name":"Texas Tech University Health Sciences Center El Paso"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zuber D.","family":"Mulla","sequence":"additional","affiliation":[{"name":"Texas Tech University Health Sciences Center El Paso"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanja Kupesic","family":"Plavsic","sequence":"additional","affiliation":[{"name":"Texas Tech University Health Sciences Center El Paso"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2018,11,2]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.071577"},{"key":"e_1_3_2_3_2","first-page":"1","article-title":"First births to older women continue to rise","author":"Matthews TJ","year":"2014","unstructured":"Matthews TJ, , Hamilton BE. First births to older women continue to rise. NCHS Data Brief, 2014; 1\u20138.","journal-title":"NCHS Data Brief"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000140682.63746.be"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2009.08.022"},{"key":"e_1_3_2_6_2","first-page":"1","article-title":"Births: final data for 2001","volume":"51","author":"Martin JA","year":"2002","unstructured":"Martin JA, , Hamilton BE, , Ventura SJ, , Menacker F, , Park MM, , Sutton PD. Births: final data for 2001. Natl Vital Stat Rep, 2002; 51:1\u2013102.","journal-title":"Natl Vital Stat Rep"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-015-1914-8"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.13020"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1447-0756.2008.00855.x"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2010.07.039"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.tjog.2012.01.012"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.2012.01442.x"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.070150"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2005.07.014"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0266-6138(97)90059-0"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-011-2099-z"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2016.1253058"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.3109\/01443615.2013.767786"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/der469"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/287519"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1047-2797(01)00278-2"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwi188"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.2217\/WHE.10.26"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1080\/01443610902929537"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1028-4559(08)60131-X"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.09.103"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1111\/ajo.12611"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.2005.00333.x"},{"key":"e_1_3_2_29_2","first-page":"287","article-title":"Impact of labor induction, gestational age, and maternal age on cesarean delivery rates","volume":"102","author":"Heffner LJ","year":"2003","unstructured":"Heffner LJ, , Elkin E, , Fretts RC. Impact of labor induction, gestational age, and maternal age on cesarean delivery rates. Obstet Gynecol, 2003; 102:287\u2013293.","journal-title":"Obstet Gynecol"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2012.684108"},{"key":"e_1_3_2_31_2","first-page":"129","article-title":"The changing epidemiology of multiple births in the United States","volume":"101","author":"Russell RB","year":"2003","unstructured":"Russell RB, , Petrini JR, , Damus K, , Mattison DR, , Schwarz RH. The changing epidemiology of multiple births in the United States. Obstet Gynecol, 2003; 101:129\u2013135.","journal-title":"Obstet Gynecol"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2013.10.623"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-010-1459-4"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)62233-7"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12494"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2005.08.058"}],"container-title":["Journal of Women's Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/jwh.2018.7027","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/jwh.2018.7027","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/jwh.2018.7027","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T17:48:42Z","timestamp":1777657722000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/jwh.2018.7027"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,11]]},"references-count":35,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2018,11]]}},"alternative-id":["10.1089\/jwh.2018.7027"],"URL":"https:\/\/doi.org\/10.1089\/jwh.2018.7027","relation":{},"ISSN":["1540-9996","1931-843X"],"issn-type":[{"value":"1540-9996","type":"print"},{"value":"1931-843X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,11]]}}}