Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: THURSDAY, March 8, 1990 TAG: 9003081565
SECTION: NATIONAL/INTERNATIONAL PAGE: A1 EDITION: METRO
SOURCE: The Washington Post
DATELINE: LENGTH: Medium
Although the study found that women over 30 had higher rates of complications during pregnancy and labor, it showed that their babies were just as healthy as those born to younger mothers and were no more likely to be born prematurely. The findings should come as reassuring news to the rising numbers of American women who are choosing to delay childbearing.
The study, published in today's New England Journal of Medicine, did not address the frequency of infertility, chromosome abnormalities, miscarriages or multiple births, all of which become more common as a woman ages. Although the risk of Down's syndrome increases with the mother's age - rising from 1 in 365 for a 35-year-old mother to 1 in 32 by the age of 45 - prenatal tests are done so commonly on older pregnant women that affected pregnancies are often aborted.
Specialists also cautioned that the results may not apply to all women because the 3,917 first-time mothers studied by researchers at New York's Mount Sinai School of Medicine were predominantly white, non-smoking college graduates with medical insurance. The research team was led by Gertrud S. Berkowitz, an epidemiologist at Mount Sinai.
"I think it's a good study. People can take a fair amount of consolation in this," said John Queenan, chairman of the obstetrics and gynecology department at Georgetown University Medical School.
But, he added, "You're talking about a really rarified group of patients: the typical young, aspiring, yuppie mother . . . who is delaying having a family. You're dealing with people who have probably optimized their chances, anyway. They don't go about [having a baby] in a casual way."
National surveys show a marked trend toward later childbearing. Between 1970 and 1986, the rate of first births among women in their 30s more than doubled, and for women 40 to 44 it increased 50 percent, according to the National Center for Health Statistics.
Previous studies have reached conflicting conclusions on the question of whether waiting until after 30 to have a baby increases a woman's chances of having a complicated labor or of delivering a premature or sick infant. The New York researchers tried to resolve these questions by studying the outcomes of the pregnancies over a three-year period of first-time mothers over the age of 20 with medical insurance who gave birth at Mount Sinai Hospital.
The researchers found that women over 30 did not have a greater chance than younger women of having either a premature baby or one that was smaller than expected at birth, which would indicate poor growth while in the uterus.
There were 45 deaths among the infants born to the 3,917 women in the study. The chances of having an infant who died were 30 percent lower for mothers over 30 than for mothers in their 20s.
The older mothers, especially those over 35, showed higher rates of specific complications of pregnancy and labor, including pregnancy-related diabetes and high blood pressure, abnormalities of the placenta, uterine bleeding, and signs of "fetal distress" during labor, usually caused by inadequate oxygen reaching the baby. The so-called second stage of labor, during which the mother bears down to push the baby out, was longer in women over 30. And older women were more likely than those in their 20s to undergo Caesarean sections.
When the baby's condition right after birth was assessed by a routine measure called the Apgar score, the researchers found no difference between infants of mothers over 30 and infants of women in their 20s. However, the babies of the older women were slightly more likely to be admitted to the hospital's intensive-care nursery, perhaps reflecting a tendency for doctors to be more cautious with infants of older mothers because they regarded them as more likely to need special treatment.
by CNB