Am J Perinatol 2011; 28(5): 355-360
DOI: 10.1055/s-0030-1270117
© Thieme Medical Publishers

The Influence of Maternal Age on Pregnancy Outcome in Nulliparous Women with Twin Gestation

Anupama S.Q Kathiresan1 , Luis E. Roca1  II , Niki Istwan2 , Cheryl Desch2 , Yvette C. Cordova1 , Felipe José Tudela1 , Victor H. Gonzalez-Quintero1
  • 1Department of Obstetrics and Gynecology, University of Miami, Miami, Florida
  • 2Alere Health, Department of Clinical Research, Atlanta, Georgia
Further Information

Publication History

Publication Date:
06 December 2010 (online)

ABSTRACT

We sought to determine if outcomes of nulliparous twin pregnancies differ based on maternal age. Nulliparous women with current twin pregnancies were identified from a database of women enrolled for outpatient nursing surveillance. Data were stratified into four groups by maternal age: less than 20, 20 to 34, 35 to 39, and greater than or equal to 40 years. Maternal and neonatal outcomes for women less than 20, 35 to 39, and 40 or more were compared with 20- to 34-year-old controls using Kruskal-Wallis, Mann-Whitney, and Pearson chi-square analyses. We analyzed 2144 nulliparous twin pregnancies. Patients ≥35 years (34 to 39, 78.5% or ≥40, 85.9%) were more likely to have cesarean deliveries compared with controls 20 to 34 years old (71.2%). Women aged 35 to 39 were less likely to deliver at <37 weeks, and women in the ≥40 group were less likely to deliver at <35 weeks due to spontaneous preterm labor compared with the controls. Neonates born to women aged 35 to 39 had a greater gestational age at delivery and larger average birth weight than controls. Maternal and neonatal outcomes were not adversely influenced by advanced maternal age in nulliparous women carrying twin gestations.

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Niki IstwanR.N. 

Director, Clinical Research, Alere, Women's & Children's Health, 3200 Windy Hill Road

Suite B-100, Atlanta, GA 30339; reprints are not available from the author

Email: Niki.Istwan@alere.com

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