Impact of maternal age on intrapartum interventions and outcomes: secondary analysis of the Birthplace in England national prospective cohort study
The aim of this project was to evaluate the impact of maternal age, in particular advanced maternal age, on intrapartum interventions and outcomes that may influence the choice of planned place of birth in women with singleton pregnancies of gestation ≥37 weeks planning a vaginal birth. The study addressed the following questions:
- How does the prevalence of maternal medical and obstetric risk factors vary by maternal age? How does this vary by parity?
- What is the relationship between maternal age and intrapartum interventions and other maternal and neonatal outcomes that may influence the choice of planned place of birth? How does this vary by parity? How is the relationship influenced by the presence or absence of medical and obstetric risk factors
- For healthy older women with straightforward pregnancies, is planned birth in a non-Obstetric Unit setting associated with a lower incidence of intrapartum interventions and other outcomes requiring obstetric care compared with planned birth in an Obstetric Unit?
- At all ages ‘low risk’ women who plan birth in a non-obstetric unit setting have lower intervention rates than comparable women who plan their birth in an obstetric unit
- The chances of experiencing an intervention or outcome that requires obstetric care increase with age, even in women who do not have known risk factors.
- Younger nulliparous women appear to benefit more than older nulliparous women from the reduction in interventions associated with planned birth in a non-obstetric unit setting
- Li Y, Townend J, Rowe R, Knight M, Brocklehurst P, Hollowell J. The effect of maternal age and planned place of birth on intrapartum outcomes in healthy women with straightforward pregnancies: secondary analysis of the Birthplace national prospective cohort study. BMJ open. 2014;4(1):e004026.
- Rowe R, Li Y, Knight M, Brocklehurst P, Hollowell J. Maternal and perinatal outcomes in women planning vaginal birth after caesarean (VBAC) at home in England: secondary analysis of the Birthplace national prospective cohort study. BJOG. 2015;123(7):1123-32.