{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T20:55:47Z","timestamp":1788555347121,"version":"build-2803163510"},"reference-count":47,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2020,4,5]],"date-time":"2020-04-05T00:00:00Z","timestamp":1586044800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>There is an increase in women delivering \u226535\u00a0years of age. We analyzed the association between advanced maternal age and pregnancy outcomes in late\u2010 and postterm pregnancies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and methods<\/jats:title>\n                    <jats:p>A national cohort study was performed on obstetrical low\u2010risk women using data from the Netherlands Perinatal Registry from 1999 to 2010. We included women \u226518\u00a0years of age with a singleton pregnancy at term. Women with a pregnancy complicated by congenital anomalies, hypertensive disorders or diabetes mellitus were excluded. Composite adverse perinatal outcome was defined as stillbirth, neonatal death, meconium aspiration syndrome, 5\u2010minute Apgar score &lt;7, neonatal intensive care unit admittance and sepsis. Composite adverse maternal outcome was defined as maternal death, placental abruption and postpartum hemorrhage of &gt;1000\u00a0mL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We stratified the women into three age groups: 18\u201034 (n\u00a0=\u00a01\u00a0321\u00a0366 [reference]); 35\u201039 (n\u00a0=\u00a0286\u00a0717) and \u226540 (n\u00a0=\u00a040\u00a0909). Composite adverse perinatal outcome occurred in 1.6% in women aged 18\u201034, 1.7% in women aged 35\u201039 (relative risk [RR] 1.06, 95% confidence interval [95% CI] 1.03\u20101.08) and 2.2% in women aged\u00a0\u226540 (RR 1.38, 95% CI 1.29\u20101.47), with 5\u2010minute Apgar score &lt;7 as the factor contributing most to the outcome. Composite adverse maternal outcome occurred in 4.6% in women aged 18\u201034, 5.0% in women aged 35\u201039 (RR 1.08, 95% CI 1.06\u20101.10) and 5.2% in women aged\u00a0\u226540 (RR 1.14, 95% CI 1.09\u20101.19), with postpartum hemorrhage &gt;1000\u00a0mL as the factor contributing most to the outcome. In all age categories, the risk of adverse pregnancy outcomes was higher for nulliparous than for multiparous women. The risk of adverse outcomes increased in both nulliparous and parous women with advancing gestational age. When adjusted for parity, onset of labor and gestational age, advanced maternal age is associated with an increase in both composite adverse perinatal and maternal outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The risk of adverse pregnancy outcome increases with advancing maternal age. Women aged \u226540 have an increased risk of adverse perinatal and maternal outcome when pregnancy goes beyond 41\u00a0weeks.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aogs.13828","type":"journal-article","created":{"date-parts":[[2020,2,19]],"date-time":"2020-02-19T02:59:56Z","timestamp":1582081196000},"page":"1022-1030","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":60,"title":["Risk of adverse pregnancy outcomes of late\u2010 and postterm pregnancies in advanced maternal age: A national cohort study"],"prefix":"10.1111","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5851-3728","authenticated-orcid":false,"given":"Joep C.","family":"Kortekaas","sequence":"first","affiliation":[{"name":"Department of Obstetrics &amp; Gynecology Radboud University Medical Center Nijmegen the Netherlands"},{"name":"Department of Obstetrics and Gynecology Amsterdam UMC University of Amsterdam Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6656-2482","authenticated-orcid":false,"given":"Brenda M.","family":"Kazemier","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Amsterdam UMC University of Amsterdam Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0694-0637","authenticated-orcid":false,"given":"Judit K. J.","family":"Keulen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Amsterdam UMC University of Amsterdam Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8902-8795","authenticated-orcid":false,"given":"Aafke","family":"Bruinsma","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Amsterdam UMC University of Amsterdam Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8337-550X","authenticated-orcid":false,"given":"Ben W.","family":"Mol","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Monash University Clayton VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2705-8416","authenticated-orcid":false,"given":"Frank","family":"Vandenbussche","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynecology Radboud University Medical Center Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6958-572X","authenticated-orcid":false,"given":"Jeroen","family":"Van Dillen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynecology Radboud University Medical Center Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0392-4626","authenticated-orcid":false,"given":"Esteriek","family":"De Miranda","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Amsterdam UMC University of Amsterdam Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,4,5]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"Royal College of Obstetricians and Gynaecologists (RCOG).Induction of labour at term in older mothers. 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