{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T06:55:07Z","timestamp":1793170507158,"version":"4.5.0"},"reference-count":19,"publisher":"Wiley","issue":"s1","license":[{"start":{"date-parts":[[2014,3,18]],"date-time":"2014-03-18T00:00:00Z","timestamp":1395100800000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2014,3]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the association between advanced maternal age (<jats:styled-content style=\"fixed-case\">AMA<\/jats:styled-content>) and adverse pregnancy outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Secondary analysis of the facility\u2010based, cross\u2010sectional data of the <jats:styled-content style=\"fixed-case\">WHO M<\/jats:styled-content>ulticountry <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>urvey on <jats:styled-content style=\"fixed-case\">M<\/jats:styled-content>aternal and <jats:styled-content style=\"fixed-case\">N<\/jats:styled-content>ewborn <jats:styled-content style=\"fixed-case\">H<\/jats:styled-content>ealth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Settings<\/jats:title><jats:p>A total of 359 health facilities in 29 countries in <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>frica, <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>sia, <jats:styled-content style=\"fixed-case\">L<\/jats:styled-content>atin <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>merica, and the <jats:styled-content style=\"fixed-case\">M<\/jats:styled-content>iddle <jats:styled-content style=\"fixed-case\">E<\/jats:styled-content>ast.<\/jats:p><\/jats:sec><jats:sec><jats:title>Sample<\/jats:title><jats:p>A total of 308\u00a0149 singleton pregnant women admitted to the participating health facilities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We estimated the prevalence of pregnant women with advanced age (35\u00a0years or older). We calculated adjusted odds ratios of individual severe maternal and perinatal outcomes in these women, compared with women aged 20\u201334\u00a0years, using a multilevel, multivariate logistic regression model, accounting for clustering effects within countries and health facilities. The confounding factors included facility and individual characteristics, as well as country (classified by maternal mortality ratio level).<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Severe maternal adverse outcomes, including maternal near miss (<jats:styled-content style=\"fixed-case\">MNM<\/jats:styled-content>), maternal death (<jats:styled-content style=\"fixed-case\">MD<\/jats:styled-content>), and severe maternal outcome (<jats:styled-content style=\"fixed-case\">SMO<\/jats:styled-content>), and perinatal outcomes, including preterm birth (&lt;37\u00a0weeks of gestation), stillbirths, early neonatal mortality, perinatal mortality, low birthweight (&lt;2500\u00a0g), and neonatal intensive care unit (<jats:styled-content style=\"fixed-case\">NICU<\/jats:styled-content>) admission.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The prevalence of pregnant women with <jats:styled-content style=\"fixed-case\">AMA<\/jats:styled-content> was 12.3% (37\u00a0787\/308\u00a0149). Advanced maternal age significantly increased the risk of maternal adverse outcomes, including <jats:styled-content style=\"fixed-case\">MNM<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> MD<\/jats:styled-content>, and <jats:styled-content style=\"fixed-case\">SMO<\/jats:styled-content>, as well as the risk of stillbirths and perinatal mortalities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Advanced maternal age predisposes women to adverse pregnancy outcomes. The findings of this study would facilitate antenatal counselling and management of women in this age category.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.12659","type":"journal-article","created":{"date-parts":[[2014,3,18]],"date-time":"2014-03-18T11:53:38Z","timestamp":1395143618000},"page":"49-56","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":374,"title":["Advanced maternal age and pregnancy outcomes: a multicountry assessment"],"prefix":"10.1111","volume":"121","author":[{"given":"M","family":"Laopaiboon","sequence":"first","affiliation":[{"name":"Faculty of Public Health Department of Biostatistics &amp; Demography Khon Kaen University Khon Kaen Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Lumbiganon","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Department of Obstetrics &amp; Gynaecology Khon Kaen University Khon Kaen Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N","family":"Intarut","sequence":"additional","affiliation":[{"name":"Faculty of Public Health Department of Biostatistics &amp; Demography Khon Kaen University Khon Kaen Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Mori","sequence":"additional","affiliation":[{"name":"Department of Health Policy National Center for Child Health and Development Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T","family":"Ganchimeg","sequence":"additional","affiliation":[{"name":"Department of Health Policy National Center for Child Health and Development Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JP","family":"Vogel","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Dentistry and Health Sciences School of Population Health University of Western Australia Crawley Australia"},{"name":"Department of Reproductive Health and Research UNDP\/UNFPA\/UNICEF\/WHO\/World Bank Special Programme of Research Development and Research Training in Human Reproduction (HRP) World Health Organization Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JP","family":"Souza","sequence":"additional","affiliation":[{"name":"Department of Reproductive Health and Research UNDP\/UNFPA\/UNICEF\/WHO\/World Bank Special Programme of Research Development and Research Training in Human Reproduction (HRP) World Health Organization Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AM","family":"G\u00fclmezoglu","sequence":"additional","affiliation":[{"name":"Department of Reproductive Health and Research UNDP\/UNFPA\/UNICEF\/WHO\/World Bank Special Programme of Research Development and Research Training in Human Reproduction (HRP) World Health Organization Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the WHO Multicountry Survey on Maternal Newborn Health Research Network","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,3,18]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp048087"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-010-1587-x"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2009.08.022"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0056583"},{"key":"e_1_2_6_6_1","unstructured":"CDC.Vitalstats. 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