000			04764cam a2200217 4500
001			NMDX6660
008			120401t2014 xxu||||| |||| 00| 0 eng d
022			_a09320067
100			_aMehta, S.
240			_aArchives of gynecology and obstetrics.
245			_aPregnancy outcomes in women greater than 45 years: a cohort control study in a multi-ethnic inner city population.
260			_c2014
500			_aNMUH Staff Publications
500			_a289
520			_a<div style="line-height: 17.999801635742188px;"><h4 style="font-size: 1em; font-family: arial, helvetica, clean, sans-serif; margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left;">OBJECTIVE:</h4><p style="margin: 0px 0px 0.5em;"><span style="font-size: 8pt;">To examine the <span class="highlight">pregnancy</span> <span class="highlight">outcomes</span> of <span class="highlight">women</span> ><span class="highlight">45</span> <span class="highlight">years</span> in a <span class="highlight">multi-ethnic</span> <span class="highlight">population</span> when compared to controls and to reflect on socio-demographic details of the older mothers.</span></p><h4 style="margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left;"><span style="font-size: 8pt;">DESIGN:</span></h4><p style="margin: 0px 0px 0.5em;"><span style="font-size: 8pt;">A retrospective <span class="highlight">cohort</span> <span class="highlight">control</span> <span class="highlight">study</span> over an 8-year period in an <span class="highlight">inner</span> <span class="highlight">city</span> London hospital with <span class="highlight">multi-ethnic</span> <span class="highlight">population</span>. The influence of advanced maternal age (><span class="highlight">45</span> <span class="highlight">years</span> at time of delivery) on fetal and maternal <span class="highlight">outcomes</span> was assessed by comparing these <span class="highlight">women</span> to controls (aged 20-30 <span class="highlight">years</span>) matched for ethnicity, country of origin and parity.</span></p><h4 style="margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left;"><span style="font-size: 8pt;">RESULTS:</span></h4><p style="margin: 0px 0px 0.5em;"><span style="font-size: 8pt;">Data from 64 cases and 64 controls were compared. Ninety percent of the index group had undergone assisted conception. Mothers ><span class="highlight">45</span><span class="highlight">years</span> had a fourfold increase in cesarean section (35/64 vs 8/64), a threefold increase in blood loss (669.2 vs 272.4 ml) (both p < 0.001) and were more likely to have preterm birth (12/64 vs 3/64) (p < 0.05). Only 5 % of the 64 <span class="highlight">women</span> were born in the United Kingdom, 52 % were unemployed and 50 % were not fluent in English. Seventy-five percent of the <span class="highlight">study</span> <span class="highlight">population</span> were multiparous, 52 % of the pregnancies were unplanned and 90 % had conceived spontaneously.</span></p><h4 style="margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left;"><span style="font-size: 8pt;">CONCLUSION:</span></h4><p style="margin: 0px 0px 0.5em;"><span style="font-size: 8pt;">In an <span class="highlight">inner</span> <span class="highlight">city</span> immigrant <span class="highlight">population</span>, older mothers ><span class="highlight">45</span> <span class="highlight">years</span> were more likely to have cesarean sections, postpartum hemorrhage and premature deliveries. Moreover, social and demographic factors suggest that late child bearing is influenced by cultural factors such as acceptance of large families and lack of contraception.</span></p></div>
700			_aTran, K.
700			_aStewart, L.
700			_aSoutte, E.
700			_aNauta, M.
700			_aYoong, W.
999			_c75816 _d75816