IMPROVING PREGNANCY AND CHILDBIRTH OUTCOMES IN WOMEN OF ADVANCED REPRODUCTIVE AGE

Аннотация

Advanced maternal age (AMA) is increasingly common in modern obstetric practice and is associated with a higher risk of complications for both mother and fetus. This prospective, multicenter observational study investigates strategies to improve pregnancy and childbirth outcomes in women aged 35 years and older. A total of 600 pregnant women were enrolled, with 300 AMA subjects and 300 age-matched controls receiving standard care. Data on maternal comorbidities, obstetric interventions, and perinatal outcomes were collected. The study implemented a multidisciplinary management protocol—including preconception counseling, individualized antenatal surveillance, optimized management of comorbidities, and tailored intrapartum care—for the AMA group [1]. Compared with controls, the AMA cohort initially demonstrated higher incidences of gestational diabetes, hypertensive disorders, preterm birth, and cesarean delivery. However, after implementing the targeted intervention protocol, significant improvements were observed: a 25% reduction in preterm delivery rates (from 18% to 13%, p < 0.01) and a 20% decrease in cesarean delivery rates (from 40% to 32%, p < 0.05). Multivariate regression analysis confirmed that the multidisciplinary protocol was independently associated with improved perinatal outcomes. These findings support the need for specialized, integrated care for women of advanced reproductive age to mitigate risks and optimize maternal–fetal health [2].