YOUNGER MOTHERS ARE at a higher risk of premature birth, while older mothers are more likely to have a caesarean, says a new study.

The study, published in BJOG: An International Journal of Obstetrics and Gynaecology, suggests that while younger mothers are at a higher risk of preterm birth, older mothers are more likely to have a caesarean section.

Maternal age

Conducted over a 12-year period (from 2000-2011) in Ireland, it examined the delivery outcomes of 36,916 first-time mothers at varying maternal ages.

The pregnant women were subdivided into five age groups:

• 3.3 per cent at 17 years or younger (17-)
• 7.2 per cent at 18-19 years
• 77.9 per cent at 20-34 years
• 9.9 per cent at 35-39 years
• 1.7 per cent at 40 years or older (40+).

However, researchers focused on the outcomes in the groups of women at the “extremes of maternal age”, 17- and 40+.

Caesarean vs maternal age

Compared to the comparison group (20-34 years), women in the 17- group were the least likely to have a caesarean section (10.7 per cent) while women in the 40+ group were the most likely, with a three-fold increase risk of caesarean section (54.4 per cent).

Women in the 17- group were at a much higher risk for preterm birth (9.8 per cent vs 5.9 per cent), and babies born to mothers in the 40+ group were more likely to require neonatal admission (23.5 per cent vs 16.8 per cent). They were also more likely to be born with congenital anomaly, when compared to the comparison group (20-34 years).

The authors said that younger mothers were more likely to be underweight and smoke during pregnancy, while older mothers were at an increased risk of being obese or having underlying medical disorders, such as hypertension or diabetes.

Professor Deirdre Murphy, Department of Obstetrics & Gynaecology, University of Dublin and co-author of the paper, said that the findings are consistent with previous literature, “highlighting the fact that maternal age continues to be an important risk factor for adverse outcomes in pregnancy”.

There was a marked difference in the rate of caesarean sections, increasing with maternal age, and more research is needed to explore the care provided to younger mothers and whether their enhanced ability to deliver naturally may suggest a reduction is possible for overall caesarean section rates.

She said that most healthcare professionals agree that management of a woman’s first birth is likely to have the biggest impact on future pregnancy outcomes.  She concluded that this means maternal age is an important risk factor to be considered when planning care for first-time mothers, particularly those at the extremes of maternal age.

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