Maternal Age and Outcome of Pregnancy

To the Editor: The article by Berkowitz et al. (March 8 issue) 1 suggested that "advancing maternal age at first birth does not appreciably increase the risk of an adverse outcome in singleton gestations." The odds ratios for perinatal deaths they present suggest that older primiparas may have an advantage over younger women, although the smallness of their sample means that the confidence intervals of these ratios are large. The sample was of private patients and may not take into account influences other than age (such as social status) in producing this result. The findings of their study may thus not . . .