Evidence map›Paper›PMID 40281462›Full record

ArticleBMC pregnancy and childbirth2025

Pregnancy outcomes among women near the end of reproductive age.

Usama Chonnak, Saipin Pongsatha, Suchaya Luewan, Sirinart Sirilert, Theera Tongsong

Abstract read
In one paragraph

Article in BMC pregnancy and childbirth, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Usama ChonnakDepartment of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
Saipin PongsathaDepartment of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand. saipin.pongsatha@cmu.ac.th.
Suchaya LuewanDepartment of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
Sirinart SirilertDepartment of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
Theera TongsongDepartment of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand. theera.t@cmu.ac.th.

Funding

Chiang Mai University CMU-2566
6 · The paper itself

Abstract

objectiveTo investigate the outcomes of pregnancies at extreme fertility age, (≥ 45 years).

methodsA retrospective cohort study was undertaken on women who gave birth at a tertiary center, Thailand, (1992-2022) to compare pregnancy outcomes between women of (≥ 45 years and those of the reproductive age (20-34 years).

resultsOf 67,301 pregnancies, 121women at age of ≥ 45, as the study group, and 51,315 controls were included in analysis. The study group had a much higher prevalence of fetal trisomy (9.1% vs. 0.1%) and medical disorders. After excluding cases with abortion and severe anomalies, the rates of preterm birth (39.6% vs. 14.5%; relative risk of 2.73, 95% CI: 2.14-3.47), low birth weight (41.2% vs. 14.5%, relative risk of 2.85, 95% CI: 2.26-3.59), fetal growth restriction, preeclampsia, gestational diabetes, cesarean section, low Apgar score, stillbirth and miscarriage were significantly higher in the study group. After excluding cases with underlying diseases, such adverse outcomes were still significantly higher in the study group, for example; preterm birth rate was still as high as 36.8%. In multivariate analysis, extremely advanced maternal age remains an independent risk factor for preeclampsia, preterm birth, fetal growth restriction, and low birth weight, even after adjusting for other potential risk factors.

conclusionThe age of ≥ 45 was at the 99.8th percentile among Thai population, implying a very close proximity to the end of reproductive life. The rates of fetal trisomy, preterm birth, low birth weight, fetal growth restriction, and other adverse outcomes were markedly higher than ever reported, even after excluding cases with underlying diseases. When compared to previous studies, the much higher adverse outcomes were likely caused by more advanced fertility age despite the same chronological age. CLINICAL TRIAL NUMBER: Not applicable.

Indexed as

Maternal AgePregnancy ComplicationsPregnancy OutcomeAbortion, SpontaneousAdultFemaleFetal Growth RetardationHumansInfant, Low Birth WeightInfant, NewbornMiddle AgedPregnancyPremature BirthRetrospective StudiesStillbirthThailandAdvanced maternal ageFertility ageLow birth weightPregnancy outcomePreterm birthTrisomy

Identifiers

PMID40281462
PMCPMC12023533

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.