Delaying motherhood – an increasingly common but risky trend in high-income countries

Objectives: Maternal age at first birth is increasing in most high-income countries. The associations between advanced maternal age and perinatal complications, as well as newborn parameters, were analyzed using a dataset of 6831 singleton births among first-time mothers taking place in Vienna, Austria, between 2010 and 2019. Methods: In this single-center medical records-based retrospective study, the following obstetrical parameters have been included: conception mode, preterm birth (< 37th gestational week), labor induction, planned or emergency cesarean sections, adverse child presentation, newborn size, and Apgar scores. The outcomes of first-time mothers older than 35 and 40 years, respectively, were compared to a reference group of first-time mothers aged between 20 and 34 years. Results: First-time mothers aged 35 and older show a significantly (p < 0.009 resp. p < 0.001) higher risk of preterm births, with a 1.32-fold risk for women between 35 and 39 years and a 2.35-fold risk for women aged 40 and older. Maternal age is also significantly (p < 0.001) associated with an increased rate of medically induced labor, cesarean sections, and low-weight newborns (< 2500 g). In contrast, there was no significant difference in Apgar scores among the newborns of different maternal age groups. Conclusions: Advanced maternal age at first birth is a relevant risk factor for certain obstetric and neonatal complications. Delaying motherhood is a risky trend.