{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:25:34Z","timestamp":1791822334109,"version":"4.3.4"},"reference-count":27,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2016,10,19]],"date-time":"2016-10-19T00:00:00Z","timestamp":1476835200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100002341","name":"Suomen Akatemia","doi-asserted-by":"publisher","award":["127402"],"award-info":[{"award-number":["127402"]}],"id":[{"id":"10.13039\/501100002341","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2016,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>It is poorly understood if there are specific ages at which adverse outcomes during pregnancy and childbirth start to increase (threshold\u2010ages). The purpose of this study was to examine at which maternal ages the use of maternity care and the risks for adverse maternal and infant outcomes increase.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>National data from the Finnish Medical Birth Register including all first\u2010time mothers aged 20 years or over with singleton pregnancies in 2005\u20132014 were analyzed (<jats:italic>n<\/jats:italic> = 228 348). Odds ratios for each outcome at different ages were calculated by logistic regression, using women aged 20\u201324 (<jats:italic>n<\/jats:italic> = 56 282) as the reference and adjusting for socioeconomic position and urbanity of residence. The threshold\u2010age was defined as the first significant adjusted odds ratio after which the risk remained significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The threshold\u2010ages for use of maternity care varied from 25 years for cesarean section (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 1.08, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.03\u20131.14) to 38 years for having 16 or more antenatal visits (1.13, 1.04\u20131.21). Four threshold\u2010ages were found for maternal health outcomes: 25 years for gestational diabetes (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 1.15, 1.09\u20131.23), 27 years for placenta previa (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 1.75, 1.11\u20132.75), 33 years for gestational hypertension (1.14, 1.03\u20131.27), and 38 years for preeclampsia (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 1.48, 1.12\u20131.96). The threshold\u2010ages for infant health outcomes varied from 28 years for preterm birth (37 weeks, <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 1.10, 1.02\u20131.19) to 36 years for perinatal mortality (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 2.10, 1.44\u20133.07).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Different threshold\u2010ages were identified. Most adverse outcomes occurred earlier than the traditional cut\u2010off ages for high risk pregnancy, which have been set at 35 or 40 years.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.13020","type":"journal-article","created":{"date-parts":[[2016,9,13]],"date-time":"2016-09-13T13:57:01Z","timestamp":1473775021000},"page":"1368-1375","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":75,"title":["At what age does the risk for adverse maternal and infant outcomes increase? Nationwide register\u2010based study on first births in Finland in 2005\u20132014"],"prefix":"10.1111","volume":"95","author":[{"given":"Reija","family":"Klemetti","sequence":"first","affiliation":[{"name":"National Institute for Health and Welfare (THL) Helsinki Finland"},{"name":"Department of Public Health Helsinki University Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8254-7525","authenticated-orcid":false,"given":"Mika","family":"Gissler","sequence":"additional","affiliation":[{"name":"National Institute for Health and Welfare (THL) Helsinki Finland"},{"name":"Division of Family Medicine Department of Neurobiology Care Sciences and Society Karolinska Institute Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanna","family":"Sainio","sequence":"additional","affiliation":[{"name":"FCR Blood Service Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elina","family":"Hemminki","sequence":"additional","affiliation":[{"name":"National Institute for Health and Welfare (THL) Helsinki Finland"},{"name":"Department of Public Health Helsinki University Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,10,19]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000140682.63746.be"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000163256.83313.36"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000158118.75532.51"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmr040"},{"key":"e_1_2_8_6_1","first-page":"1","article-title":"First births to older women continue to rise","volume":"15","author":"Mathews TJ","year":"2014","journal-title":"NCHS Data Brief"},{"key":"e_1_2_8_7_1","unstructured":"Medical Birth Register THL 2014. 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