Effect of Advanced Maternal Age on Pregnancy Outcome: A Retrospective Study from Three Academic Teaching Hospitals in Indonesia

Background & Objective: Pregnancy at advanced maternal age (AMA), defined as pregnancy in women aged >35 years, has been increasing globally, including in Indonesia. AMA is associated with higher risks of adverse pregnancy outcomes, making it a significant clinical and public health concern. This study aims to evaluate the negative maternal and fetal outcomes associated with AMA pregnancies.Materials & Methods: A retrospective cohort study was conducted at three academic teaching hospitals in West Java, Indonesia, from January 1 to December 31, 2022. Data were collected from medical records, comparing a study group of women aged >35 years with a control group of women aged <35 years. Pregnant women beyond 28 weeks of gestation, both primiparous and multiparous, were included. Maternal outcomes assessed were antepartum hemorrhage, gestational diabetes, hypertensive disorders, and cesarean delivery. Fetal outcomes included preterm labor and intrauterine fetal death (IUFD). Statistical analysis was performed using the Chi-square test with a 95% confidence interval.Results: A total of 6763 patients were analyzed, including 1743 AMA women and 5020 younger women. AMA pregnancies showed a significantly higher incidence of antepartum hemorrhage (P<0.001; OR = 1.94 [1.55–2.42]), hypertensive pregnancy (P<0.001; OR = 1.90 [1.65–2.19]), and IUFD (P = 0.004; OR = 1.49 [1.13–1.95]).Conclusion: AMA pregnancies are associated with increased risks of maternal and fetal complications. Significant increases in antepartum hemorrhage, hypertensive disorders, and IUFD highlight the need for enhanced prenatal monitoring and risk management in this population.