Do Hypertensive Disorders of Pregnancy and Abnormal  Placentation Mediate the Association between Advanced  Maternal Age and Adverse Perinatal Outcomes?

Hui  Li; Nawsherwan; Abbas  Khan; Ijaz   Ul Haq; Shi Yuan  Mei

doi:10.18502/ijph.v51i5.9421

Hui Li Department of Medicine, Taixing People Hospital, Taizhou, Jiangsu, China
Nawsherwan Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan, Hubei, China
Abbas Khan Department of Nutrition and Health Promotion, University of Home Economics, Lahore, Pakistan
Ijaz Ul Haq Department of Public Health and Nutrition, The University of Haripur, Khyber Pakhtunkhwa, Pakistan
Shi Yuan Mei Department of Pediatrics, Taixing People Hospital, Taizhou, Jiangsu, China

DOI: https://doi.org/10.18502/ijph.v51i5.9421

Keywords: Advanced maternal age; Hypertensive disorders of pregnancy; Abnormal placentation; Adverse perinatal outcomes

Abstract

Background: A tertiary-hospital-based retrospective study (2011-2019) was conducted to determine the mediating role of hypertensive disorders of pregnancy and abnormal placentations between advanced maternal age and adverse neonatal outcomes.

Methods: Data from a tertiary-hospital-based retrospective study (n= 23051) was used and conducted regression-based mediation analysis to assess the mediating role of hypertensive disorders of pregnancy and abnormal placentation between the advanced maternal age and adverse neonatal outcomes.

Results: After adjusting for confounding factors, the indirect effect of advanced maternal age on preterm births, perinatal mortality, and low birth weight mediated by hypertensive disorders of pregnancy was [aOR 4.95 (95% CI: 4.05, 5.85)], [aOR 2.82 (95% CI: 1.78, 3.86)], and [aOR 5.90 (95% CI: 4.93, 6.87)], respectively. The indirect effect of advanced maternal age on preterm births and low birth weight mediated by abnormal placentation was [aOR 6.83 (95% CI: 5.70, 7.97)] and [aOR 4.18 (95% CI: 3.26, 5.11)]. About, 23%, 37%, and 17% of the effect of advanced maternal age on preterm births, perinatal mortality, and low birth weight was mediated by hypertensive disorders of pregnancy, respectively. Furthermore, abnormal placentation mediates the association between advanced maternal age and preterm births by 18% and low birth weight by 23%.

Conclusion: Hypertensive disorders of pregnancy and abnormal placentation partially mediate the association between advanced maternal age and adverse neonatal outcomes.