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Comparison of Demographic and Obstetric Characteristics of Canadian Primiparous Women of Advanced Maternal Age and Younger Age

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      Abstract

      Objective

      The rate of pregnancy at advanced maternal age (AMA) has increased during recent decades. The purpose of this study is to compare demographic and obstetric characteristics of Canadian primiparous women of AMA with those aged 20 to 29 years.

      Methods

      We conducted a secondary analysis of data collected through the national Maternity Experiences Survey (MES) of the Canadian Perinatal Surveillance System. The sample included 301 primiparous women aged 35 years or over and 1564 primiparous women aged 20 to 29 years. Estimates of prevalence for each group and their odds ratios were calculated using sample weights of the survey, and variances were calculated using bootstrapping methods adjusting for sampling design and weights.

      Results

      Women of AMA were significantly more likely to be better educated, to have higher income, to be employed, and to continue to work until the end of pregnancy than younger women. They also reported having significantly more information on pregnancy, labour, and birth, and they were more likely to attend prenatal classes. They were more likely to have had a miscarriage or infertility treatment, to request or be offered a Caesarean section, and to have a higher rate of Caesarean section. There were no significant differences in rates of preterm birth, low birth weight, and small-for-gestational age infants.

      Conclusion

      Pregnant women of AMA differ from younger women in demographic characteristics, knowledge level, and some health behaviours and pregnancy outcomes. The growing number of pregnancies at AMA indicates the need for developing appropriate care plans to address the specific needs of this group.

      Résumé

      Objectif

      Le taux de grossesse à un âge maternel avancé (AMA) a connu une hausse au cours des dernières décennies. Cette étude avait pour but de comparer les caractéristiques démographiques et obstétricales des primipares canadiennes d’AMA à celles des femmes de 20 à 29 ans.

      Méthodes

      Nous avons mené une analyse secondaire des données recueillies au moyen de l’Enquête sur l’expérience de la maternité (EEM) nationale du Système canadien de surveillance périnatale. L’échantillon comprenait 301 primipares de 35 ans ou plus et 1 564 primipares de 20 à 29 ans. Les estimations de la prévalence pour chacun des groupes et leurs rapports de cotes ont été calculés au moyen des poids d’échantillonnage de l’enquête, et les variances ont été calculées au moyen de méthodes d’amorçage neutralisant l’effet du modèle et des poids d’échantillonnage

      Résultats

      Les femmes d’AMA étaient considérablement plus susceptibles de disposer d’un meilleur niveau de scolarité, de présenter un revenu supérieur, d’avoir un emploi et de continuer à travailler jusqu’à la fin de la grossesse, par comparaison avec les femmes moins âgées. Elles ont également signalé qu’elles disposaient de considérablement plus de renseignements sur la grossesse, le travail et l’accouchement; de surcroît, elles étaient plus susceptibles de participer à des cours prénataux Elles étaient également plus susceptibles d’avoir déjà connu une fausse couche ou d’avoir subi un traitement contre l’infertilité, de demander ou de se voir offrir une césarienne et de présenter un taux accru de césarienne. Nous n’avons constaté aucune différence significative en matière de taux d’accouchement préterme, de faible poids de naissance et d’hypotrophie fœtale.

      Conclusion

      Les femmes enceintes d’AMA présentent des différences en matière de caractéristiques démographiques, de niveau de connaissances et de certains comportements de santé et de certaines issues de grossesse, par comparaison avec les femmes moins âgées Le nombre croissant des grossesses à un AMA souligne la nécessité de formuler des plans de soins appropriés répondant aux besoins particuliers de ce groupe.

      Key Words

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