ArticleFrontiers in global women's health2023
Maternal age extremes and adverse pregnancy outcomes in low-resourced settings.
Article in Frontiers in global women's health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Maternal age 30-34 years and adverse perinatal outcomes: a systematic review and meta-analysis.Frontiers in medicine · 2026Pooled it
- Binational Analysis of Maternal Mortality Between Brazil and Portugal in 2020-2023: A Population-Based Epidemiological Study.Nursing reports (Pavia, Italy) · 2026Article
- Bypassing primary healthcare facilities for maternal and child health services in low- and middle-income countries: a scoping review.Reproductive health · 2026Article
- Prehospital emergency response and management of pregnancy-associated haemorrhage in KwaZulu-Natal Province, South Africa: A Retrospective Cross-Sectional Study.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2025Article
- Advanced maternal age increases the risk of adverse neonatal outcomes: a comparative study in Ethiopia.BMC pregnancy and childbirth · 2025Article
- Trends and regional disparities in maternal hypertensive disorders among women of childbearing age: a global burden of disease analysis from 1990 to 2021.BMC pregnancy and childbirth · 2025Article
- Comparative study of pregnancy risks in different maternal age groups.Saudi medical journal · 2025Article
- Adverse obstetrical outcomes among adolescents in North Wollo Zone Governmental hospitals, Northern Ethiopia.Scientific reports · 2025Article
- Global burden, trends and inequalities of maternal hypertensive disorders among reproductive-age women of advanced maternal age, 1990-2021: a population-based study.Frontiers in global women's health · 2025Article
- Comparing adverse maternal outcomes among adolescent and adult women in North Wollo Zone governmental hospitals, northern Ethiopia.Frontiers in global women's health · 2025Article
- Development and validation of an epidemiological risk score for neonatal death in a middle-income country.Frontiers in public health · 2025Article
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27 authors.
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Abstract
Introduction: Adolescent (<20 years) and advanced maternal age (>35 years) pregnancies carry adverse risks and warrant a critical review in low- and middle-income countries where the burden of adverse pregnancy outcomes is highest. Objective: To describe the prevalence and adverse pregnancy (maternal, perinatal, and neonatal) outcomes associated with extremes of maternal age across six countries. Patients and methods: We performed a historical cohort analysis on prospectively collected data from a population-based cohort study conducted in the Democratic Republic of Congo, Guatemala, India, Kenya, Pakistan, and Zambia between 2010 and 2020. We included pregnant women and their neonates. We describe the prevalence and adverse pregnancy outcomes associated with pregnancies in these maternal age groups (<20, 20-24, 25-29, 30-35, and >35 years). Relative risks and 95% confidence intervals of each adverse pregnancy outcome comparing each maternal age group to the reference group of 20-24 years were obtained by fitting a Poisson model adjusting for site, maternal age, parity, multiple gestations, maternal education, antenatal care, and delivery location. Analysis by region was also performed. Results: We analyzed 602,884 deliveries; 13% (78,584) were adolescents, and 5% (28,677) were advanced maternal age (AMA). The overall maternal mortality ratio (MMR) was 147 deaths per 100,000 live births and increased with advancing maternal age: 83 in the adolescent and 298 in the AMA group. The AMA groups had the highest MMR in all regions. Adolescent pregnancy was associated with an adjusted relative risk (aRR) of 1.07 (1.02-1.11) for perinatal mortality and 1.13 (1.06-1.19) for neonatal mortality. In contrast, AMA was associated with an aRR of 2.55 (1.81 to 3.59) for maternal mortality, 1.58 (1.49-1.67) for perinatal mortality, and 1.30 (1.20-1.41) for neonatal mortality, compared to pregnancy in women 20-24 years. This pattern was overall similar in all regions, even in the <18 and 18-19 age groups. Conclusion: The maternal mortality ratio in the LMICs assessed is high and increased with advancing maternal age groups. While less prevalent, AMA was associated with a higher risk of adverse maternal mortality and, like adolescence, was associated with adverse perinatal mortality with little regional variation.
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