Pregnancy in the Sixth Decade of Life: Obstetric Outcomes in Women of Advanced Reproductive Age
CONTEXT As a result of oocyte donation, women in their sixth decade of life are now able to conceive and carry pregnancies to term. However, little is known about pregnancy outcomes in this population. OBJECTIVE To describe pregnancy outcomes in women aged 50 years or older who conceived after in vi...
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| Veröffentlicht in: | JAMA : the journal of the American Medical Association 2002-11, Vol.288 (18), p.2320-2323 |
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| creator | Paulson, Richard J Boostanfar, Robert Saadat, Peyman Mor, Eliran Tourgeman, David E Slater, Cristin C Francis, Mary M Jain, John K |
| description | CONTEXT As a result of oocyte donation, women in their sixth decade of life
are now able to conceive and carry pregnancies to term. However, little is
known about pregnancy outcomes in this population. OBJECTIVE To describe pregnancy outcomes in women aged 50 years or older who conceived
after in vitro fertilization with donor oocytes. DESIGN AND SETTING Retrospective analysis of cycles conducted at a US university assisted
reproduction program during calendar years 1991-2001. PATIENTS Seventy-seven postmenopausal women with no chronic medical conditions
(mean [SD] age, 52.8 [2.9] years; range, 50-63 years) who underwent 121 embryo
transfer procedures (89 fresh and 32 frozen). Pregnancy outcomes were ascertained
by chart review and telephone follow-up. MAIN OUTCOME MEASURES Maternal and neonatal outcomes. RESULTS There were 55 clinical pregnancies for a total pregnancy rate of 45.5%.
The live birth rate was 37.2%. Of the 45 live births, 31 were singletons,
12 were twins, and 2 were triplets, for which the mean (SD) gestational ages
at delivery were 38.4 (2.1) weeks, 35.8 (2.8) weeks, and 32.2 weeks, respectively.
Mean (SD) birth weights were 3039 g (703 g), 2254 g (581 g), and 1913 g, respectively.
Apgar scores at 1 and 5 minutes were 8.2 (0.9) and 9.1 (0.5), respectively.
Of singletons, 68% were delivered by cesarean, and all multiples were delivered
by cesarean. Mild preeclampsia was noted in 25% of patients and severe preeclampsia
in 10%. Gestational diabetes required diet modification in 17.5%, and 2.5%
required insulin. CONCLUSIONS Appropriately screened women aged 50 years or older can successfully
conceive via oocyte donation and experience similar pregnancy rates, multiple
gestation rates, and spontaneous abortion rates as younger recipients. During
pregnancy, they appear at increased risk of preeclampsia and gestational diabetes.
A majority can expect to deliver via cesarean. However, there does not appear
to be any definitive medical reason for excluding these women from attempting
pregnancy on the basis of age alone. |
| doi_str_mv | 10.1001/jama.288.18.2320 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_72680746</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><ama_id>195477</ama_id><sourcerecordid>238606941</sourcerecordid><originalsourceid>FETCH-LOGICAL-a307t-c025e96f1894dbb2b7bc005296b5ce2add9c95fac5e673c8289ac815d4afacd73</originalsourceid><addsrcrecordid>eNpd0ctLwzAcB_Agis7HXS8SBL215tE0ibcxnzCY-MBjSZNft461nU073H9vhhPBHJKQfPj-8kDolJKYEkKv56YyMVMqpipmnJEdNKCCq4gLrXbRgBCtIpmo5AAdej8noVEu99EBZQkTkpIByp5bmNamtmtc1ribAX4tv7oZvgVrHOCmwOOygBs8yX0HXVtaPOk721TgN_4jTOoNGrpVyACHX2DZNq63XbkCPJzCMdorzMLDyXY8Qu_3d2-jx2g8eXgaDceR4UR2kSVMgE4LqnTi8pzlMreECKbTXFhgxjlttSiMFZBKbhVT2lhFhUtMWHSSH6Grn9xQ_rMH32VV6S0sFqaGpveZZKkiMkkDvPgH503f1uFsGaOUExG6gM63qM8rcNmyLSvTrrPfdwvgcguMt2ZRtOH2pf9zCaGC8U3Q2Y8LH_W3q0UiJf8GjNiENA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>211305113</pqid></control><display><type>article</type><title>Pregnancy in the Sixth Decade of Life: Obstetric Outcomes in Women of Advanced Reproductive Age</title><source>MEDLINE</source><source>American Medical Association Journals</source><creator>Paulson, Richard J ; Boostanfar, Robert ; Saadat, Peyman ; Mor, Eliran ; Tourgeman, David E ; Slater, Cristin C ; Francis, Mary M ; Jain, John K</creator><creatorcontrib>Paulson, Richard J ; Boostanfar, Robert ; Saadat, Peyman ; Mor, Eliran ; Tourgeman, David E ; Slater, Cristin C ; Francis, Mary M ; Jain, John K</creatorcontrib><description>CONTEXT As a result of oocyte donation, women in their sixth decade of life
are now able to conceive and carry pregnancies to term. However, little is
known about pregnancy outcomes in this population. OBJECTIVE To describe pregnancy outcomes in women aged 50 years or older who conceived
after in vitro fertilization with donor oocytes. DESIGN AND SETTING Retrospective analysis of cycles conducted at a US university assisted
reproduction program during calendar years 1991-2001. PATIENTS Seventy-seven postmenopausal women with no chronic medical conditions
(mean [SD] age, 52.8 [2.9] years; range, 50-63 years) who underwent 121 embryo
transfer procedures (89 fresh and 32 frozen). Pregnancy outcomes were ascertained
by chart review and telephone follow-up. MAIN OUTCOME MEASURES Maternal and neonatal outcomes. RESULTS There were 55 clinical pregnancies for a total pregnancy rate of 45.5%.
The live birth rate was 37.2%. Of the 45 live births, 31 were singletons,
12 were twins, and 2 were triplets, for which the mean (SD) gestational ages
at delivery were 38.4 (2.1) weeks, 35.8 (2.8) weeks, and 32.2 weeks, respectively.
Mean (SD) birth weights were 3039 g (703 g), 2254 g (581 g), and 1913 g, respectively.
Apgar scores at 1 and 5 minutes were 8.2 (0.9) and 9.1 (0.5), respectively.
Of singletons, 68% were delivered by cesarean, and all multiples were delivered
by cesarean. Mild preeclampsia was noted in 25% of patients and severe preeclampsia
in 10%. Gestational diabetes required diet modification in 17.5%, and 2.5%
required insulin. CONCLUSIONS Appropriately screened women aged 50 years or older can successfully
conceive via oocyte donation and experience similar pregnancy rates, multiple
gestation rates, and spontaneous abortion rates as younger recipients. During
pregnancy, they appear at increased risk of preeclampsia and gestational diabetes.
A majority can expect to deliver via cesarean. However, there does not appear
to be any definitive medical reason for excluding these women from attempting
pregnancy on the basis of age alone.</description><identifier>ISSN: 0098-7484</identifier><identifier>EISSN: 1538-3598</identifier><identifier>DOI: 10.1001/jama.288.18.2320</identifier><identifier>PMID: 12425710</identifier><identifier>CODEN: JAMAAP</identifier><language>eng</language><publisher>Chicago, IL: American Medical Association</publisher><subject>Bioethics ; Biological and medical sciences ; Female ; Fertilization in Vitro ; Gynecology. Andrology. Obstetrics ; Humans ; Infant, Newborn ; Management. Prenatal diagnosis ; Medical sciences ; Middle Aged ; Older people ; Oocyte Donation ; Postmenopause ; Pregnancy ; Pregnancy Outcome ; Pregnancy. Fetus. Placenta ; Reproductive technologies ; Retrospective Studies</subject><ispartof>JAMA : the journal of the American Medical Association, 2002-11, Vol.288 (18), p.2320-2323</ispartof><rights>2003 INIST-CNRS</rights><rights>Copyright American Medical Association Nov 13, 2002</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://jamanetwork.com/journals/jama/articlepdf/10.1001/jama.288.18.2320$$EPDF$$P50$$Gama$$H</linktopdf><linktohtml>$$Uhttps://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.288.18.2320$$EHTML$$P50$$Gama$$H</linktohtml><link.rule.ids>64,314,780,784,3338,27922,27923,76259,76262</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14015233$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12425710$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Paulson, Richard J</creatorcontrib><creatorcontrib>Boostanfar, Robert</creatorcontrib><creatorcontrib>Saadat, Peyman</creatorcontrib><creatorcontrib>Mor, Eliran</creatorcontrib><creatorcontrib>Tourgeman, David E</creatorcontrib><creatorcontrib>Slater, Cristin C</creatorcontrib><creatorcontrib>Francis, Mary M</creatorcontrib><creatorcontrib>Jain, John K</creatorcontrib><title>Pregnancy in the Sixth Decade of Life: Obstetric Outcomes in Women of Advanced Reproductive Age</title><title>JAMA : the journal of the American Medical Association</title><addtitle>JAMA</addtitle><description>CONTEXT As a result of oocyte donation, women in their sixth decade of life
are now able to conceive and carry pregnancies to term. However, little is
known about pregnancy outcomes in this population. OBJECTIVE To describe pregnancy outcomes in women aged 50 years or older who conceived
after in vitro fertilization with donor oocytes. DESIGN AND SETTING Retrospective analysis of cycles conducted at a US university assisted
reproduction program during calendar years 1991-2001. PATIENTS Seventy-seven postmenopausal women with no chronic medical conditions
(mean [SD] age, 52.8 [2.9] years; range, 50-63 years) who underwent 121 embryo
transfer procedures (89 fresh and 32 frozen). Pregnancy outcomes were ascertained
by chart review and telephone follow-up. MAIN OUTCOME MEASURES Maternal and neonatal outcomes. RESULTS There were 55 clinical pregnancies for a total pregnancy rate of 45.5%.
The live birth rate was 37.2%. Of the 45 live births, 31 were singletons,
12 were twins, and 2 were triplets, for which the mean (SD) gestational ages
at delivery were 38.4 (2.1) weeks, 35.8 (2.8) weeks, and 32.2 weeks, respectively.
Mean (SD) birth weights were 3039 g (703 g), 2254 g (581 g), and 1913 g, respectively.
Apgar scores at 1 and 5 minutes were 8.2 (0.9) and 9.1 (0.5), respectively.
Of singletons, 68% were delivered by cesarean, and all multiples were delivered
by cesarean. Mild preeclampsia was noted in 25% of patients and severe preeclampsia
in 10%. Gestational diabetes required diet modification in 17.5%, and 2.5%
required insulin. CONCLUSIONS Appropriately screened women aged 50 years or older can successfully
conceive via oocyte donation and experience similar pregnancy rates, multiple
gestation rates, and spontaneous abortion rates as younger recipients. During
pregnancy, they appear at increased risk of preeclampsia and gestational diabetes.
A majority can expect to deliver via cesarean. However, there does not appear
to be any definitive medical reason for excluding these women from attempting
pregnancy on the basis of age alone.</description><subject>Bioethics</subject><subject>Biological and medical sciences</subject><subject>Female</subject><subject>Fertilization in Vitro</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Management. Prenatal diagnosis</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Older people</subject><subject>Oocyte Donation</subject><subject>Postmenopause</subject><subject>Pregnancy</subject><subject>Pregnancy Outcome</subject><subject>Pregnancy. Fetus. Placenta</subject><subject>Reproductive technologies</subject><subject>Retrospective Studies</subject><issn>0098-7484</issn><issn>1538-3598</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpd0ctLwzAcB_Agis7HXS8SBL215tE0ibcxnzCY-MBjSZNft461nU073H9vhhPBHJKQfPj-8kDolJKYEkKv56YyMVMqpipmnJEdNKCCq4gLrXbRgBCtIpmo5AAdej8noVEu99EBZQkTkpIByp5bmNamtmtc1ribAX4tv7oZvgVrHOCmwOOygBs8yX0HXVtaPOk721TgN_4jTOoNGrpVyACHX2DZNq63XbkCPJzCMdorzMLDyXY8Qu_3d2-jx2g8eXgaDceR4UR2kSVMgE4LqnTi8pzlMreECKbTXFhgxjlttSiMFZBKbhVT2lhFhUtMWHSSH6Grn9xQ_rMH32VV6S0sFqaGpveZZKkiMkkDvPgH503f1uFsGaOUExG6gM63qM8rcNmyLSvTrrPfdwvgcguMt2ZRtOH2pf9zCaGC8U3Q2Y8LH_W3q0UiJf8GjNiENA</recordid><startdate>20021113</startdate><enddate>20021113</enddate><creator>Paulson, Richard J</creator><creator>Boostanfar, Robert</creator><creator>Saadat, Peyman</creator><creator>Mor, Eliran</creator><creator>Tourgeman, David E</creator><creator>Slater, Cristin C</creator><creator>Francis, Mary M</creator><creator>Jain, John K</creator><general>American Medical Association</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7QL</scope><scope>7QP</scope><scope>7TK</scope><scope>7TS</scope><scope>7U7</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope></search><sort><creationdate>20021113</creationdate><title>Pregnancy in the Sixth Decade of Life: Obstetric Outcomes in Women of Advanced Reproductive Age</title><author>Paulson, Richard J ; Boostanfar, Robert ; Saadat, Peyman ; Mor, Eliran ; Tourgeman, David E ; Slater, Cristin C ; Francis, Mary M ; Jain, John K</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-a307t-c025e96f1894dbb2b7bc005296b5ce2add9c95fac5e673c8289ac815d4afacd73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Bioethics</topic><topic>Biological and medical sciences</topic><topic>Female</topic><topic>Fertilization in Vitro</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>Management. Prenatal diagnosis</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Older people</topic><topic>Oocyte Donation</topic><topic>Postmenopause</topic><topic>Pregnancy</topic><topic>Pregnancy Outcome</topic><topic>Pregnancy. Fetus. Placenta</topic><topic>Reproductive technologies</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Paulson, Richard J</creatorcontrib><creatorcontrib>Boostanfar, Robert</creatorcontrib><creatorcontrib>Saadat, Peyman</creatorcontrib><creatorcontrib>Mor, Eliran</creatorcontrib><creatorcontrib>Tourgeman, David E</creatorcontrib><creatorcontrib>Slater, Cristin C</creatorcontrib><creatorcontrib>Francis, Mary M</creatorcontrib><creatorcontrib>Jain, John K</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Physical Education Index</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>JAMA : the journal of the American Medical Association</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Paulson, Richard J</au><au>Boostanfar, Robert</au><au>Saadat, Peyman</au><au>Mor, Eliran</au><au>Tourgeman, David E</au><au>Slater, Cristin C</au><au>Francis, Mary M</au><au>Jain, John K</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pregnancy in the Sixth Decade of Life: Obstetric Outcomes in Women of Advanced Reproductive Age</atitle><jtitle>JAMA : the journal of the American Medical Association</jtitle><addtitle>JAMA</addtitle><date>2002-11-13</date><risdate>2002</risdate><volume>288</volume><issue>18</issue><spage>2320</spage><epage>2323</epage><pages>2320-2323</pages><issn>0098-7484</issn><eissn>1538-3598</eissn><coden>JAMAAP</coden><abstract>CONTEXT As a result of oocyte donation, women in their sixth decade of life
are now able to conceive and carry pregnancies to term. However, little is
known about pregnancy outcomes in this population. OBJECTIVE To describe pregnancy outcomes in women aged 50 years or older who conceived
after in vitro fertilization with donor oocytes. DESIGN AND SETTING Retrospective analysis of cycles conducted at a US university assisted
reproduction program during calendar years 1991-2001. PATIENTS Seventy-seven postmenopausal women with no chronic medical conditions
(mean [SD] age, 52.8 [2.9] years; range, 50-63 years) who underwent 121 embryo
transfer procedures (89 fresh and 32 frozen). Pregnancy outcomes were ascertained
by chart review and telephone follow-up. MAIN OUTCOME MEASURES Maternal and neonatal outcomes. RESULTS There were 55 clinical pregnancies for a total pregnancy rate of 45.5%.
The live birth rate was 37.2%. Of the 45 live births, 31 were singletons,
12 were twins, and 2 were triplets, for which the mean (SD) gestational ages
at delivery were 38.4 (2.1) weeks, 35.8 (2.8) weeks, and 32.2 weeks, respectively.
Mean (SD) birth weights were 3039 g (703 g), 2254 g (581 g), and 1913 g, respectively.
Apgar scores at 1 and 5 minutes were 8.2 (0.9) and 9.1 (0.5), respectively.
Of singletons, 68% were delivered by cesarean, and all multiples were delivered
by cesarean. Mild preeclampsia was noted in 25% of patients and severe preeclampsia
in 10%. Gestational diabetes required diet modification in 17.5%, and 2.5%
required insulin. CONCLUSIONS Appropriately screened women aged 50 years or older can successfully
conceive via oocyte donation and experience similar pregnancy rates, multiple
gestation rates, and spontaneous abortion rates as younger recipients. During
pregnancy, they appear at increased risk of preeclampsia and gestational diabetes.
A majority can expect to deliver via cesarean. However, there does not appear
to be any definitive medical reason for excluding these women from attempting
pregnancy on the basis of age alone.</abstract><cop>Chicago, IL</cop><pub>American Medical Association</pub><pmid>12425710</pmid><doi>10.1001/jama.288.18.2320</doi><tpages>4</tpages></addata></record> |
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| ispartof | JAMA : the journal of the American Medical Association, 2002-11, Vol.288 (18), p.2320-2323 |
| issn | 0098-7484 1538-3598 |
| language | eng |
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| source | MEDLINE; American Medical Association Journals |
| subjects | Bioethics Biological and medical sciences Female Fertilization in Vitro Gynecology. Andrology. Obstetrics Humans Infant, Newborn Management. Prenatal diagnosis Medical sciences Middle Aged Older people Oocyte Donation Postmenopause Pregnancy Pregnancy Outcome Pregnancy. Fetus. Placenta Reproductive technologies Retrospective Studies |
| title | Pregnancy in the Sixth Decade of Life: Obstetric Outcomes in Women of Advanced Reproductive Age |
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