Effect of advanced maternal age on maternal and neonatal outcomes in assisted reproductive technology pregnancies

Amirhossein Moaddab, Frank A. Chervenak, Laurence B. Mccullough, Haleh Sangi-Haghpeykar, Amir A. Shamshirsaz, Amy Schutt, Sara E. Arian, Karin A. Fox, Gary A. Dildy, Alireza A. Shamshirsaz

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


Objectives To compare maternal and neonatal outcomes between women with assisted reproductive technologies pregnancy aged <40, 40–44, 45–49, and ≥50 years. Study Design In a population-level analysis study, all live births by ART identified on birth certificate between 2011 and 2014 were extracted (n = 101,494) using data from the Center for Disease Control and Prevention-National Center for Health Statistics (CDC-NCHS). We investigated and compared maternal and neonatal outcomes based on conditions routinely listed on birth certificates. Results Of 101,494 ART live births, 79,786 (78.6%), 16,186 (15.9%), 4637 (4.6%), and 885 (0.9%) were delivered by women aged <40, 40–44, 45–49, and ≥50 years, respectively. Comparing to women aged < 40 years, women aged 40–44, 45–49, and ≥50 years were at increased risk for gestational hypertension (aRR: 1.26, 1.55, and 1.61, respectively), gestational diabetes (aRR: 1.23, 1.40, and 1.31, respectively), eclampsia (aRR: 1.49, 1.51, and 2.37, respectively), unplanned hysterectomy (aRR: 2.55, 4.05, and 3.02, respectively), and ICU admission (aRR: 1.64, 2.06, and 2.04, respectively). The prevalence of preterm delivery was slightly higher in women aged 45 and older. (35%, 36.9%, and 40.2% in women aged <40 years, 45–49 years, and ≥50 years, respectively) Conclusions Advanced age ART was significantly associated with higher rates of maternal morbidities. Except for preterm delivery, neonatal outcomes were similar between ART pregnancies in women aged ≥45 years and younger women. These data should be interpreted with caution because of potential confounding by potentially higher use of donor eggs by older women, the exact rates for which we were unable to ascertain from the available data.

Original languageEnglish (US)
Pages (from-to)178-183
Number of pages6
JournalEuropean Journal of Obstetrics and Gynecology and Reproductive Biology
StatePublished - Sep 2017
Externally publishedYes


  • Advanced maternal age
  • Assisted reproductive technology
  • In vitro fertilization
  • Pregnancy outcome

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology


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