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Mother's age tied to risk of delivery complications

By Andrew M. Seaman

NEW YORK (Reuters Health) - Teenage mothers are at increased risk of delivering their babies prematurely, while older moms are more likely to give birth via Caesarean section, according to a new study from Ireland.

"It more or less confirmed what we know from previous studies," said Dr. Deirdre Murphy, the study's senior author from Trinity College in Dublin.

Still, Murphy told Reuters Health those studies were done years ago and there have been cultural changes among women that might have influenced delivery patterns.

She and her colleagues examined data on 36,916 first-time mothers giving birth in one Irish hospital between 2000 and 2011. The researchers were especially interested in comparing the deliveries of both very young and older women to those of new moms between the ages of 20 and 34 years old.

About 3 percent of women were 17 years old or younger and close to 2 percent were 40 and above. Women between 20 and 34 years old made up about 78 percent of mothers in the study.

Overall, about 6 percent of moms in the 20 to 34 age range gave birth before 37 weeks. (A normal-length pregnancy is considered to last 37 to 42 weeks.)

That compared to about 10 percent of women in the youngest group who had a premature delivery.

Younger women, however, were least likely to deliver their babies by C-section.

The researchers found only 11 percent of the youngest group had a C-section. That compared to about 54 percent of the oldest women and 24 percent of those in between.

Babies born to older moms were also more likely to have birth defects and to be admitted to the neonatal intensive care unit.

Murphy, who published her findings in BJOG: An International Journal of Obstetrics and Gynecology, said there may be something to learn from teenagers about why they have fewer C-sections than any other age group.

Currently, about 32 percent of U.S. births are by C-section, according to the Centers for Disease Control and Prevention. Murphy said the rates are typically lower in some European countries, including Ireland and the UK.

The procedure increases the chance of bowel or bladder injuries for women, and puts babies at risk of breathing problems.

"The biggest advantage is for the second or third birth. Your subsequent deliveries are much safer if your first birth is vaginal," Murphy said.

Dr. Loralei Thornburg, a high-risk pregnancy expert at the University of Rochester Medical Center in New York, said it may be possible to apply some techniques from one age group to the others, but she cautioned that not all women may be the same.

"If you're having your first baby at 40 (years old) you're going to be less tolerant to any complication and any issues and you're going to be more prone to move toward Caesarean delivery," said Thornburg, who was not involved in the new study.

She told Reuters Health that - in this case - the older women were also more likely to be overweight and have other traits that would increase their risk for complications during delivery.

"There are mothers in every age group that do great and need very little changes to their care but you need to look at the whole package," Thornburg said.

SOURCE: http://bit.ly/11YLeqv BJOG: An International Journal of Obstetrics and Gynecology, online June 12, 2013.

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