(741) Menopausal Pregnancy – should there be a ceiling for advanced maternal age?

Friday, January 31, 2025

10:30 AM - 12:30 PM

Submitting Author and Presenting Author(s)

Dvora Kluwgant, MD, MPH

Resident PGY3
NYPBrooklyn Methodist Hospital - - Brooklyn, NY
Brooklyn, New York, United States

Coauthor(s)

TG

Tracy B. Grossman, MD, MSc

Maternal Fetal Medicine
NYPBrooklyn Methodist Hospital - Brooklyn, NY
New York, New York, United States
CA

Caroline Andy, MS

Weill Cornell Medical School
New York, New York, United States

Objective: It has been well described that pregnancies in women who are ≥ age 35 carry an increased risk of adverse maternal and neonatal outcomes. The age at which patients are becoming pregnant through reproductive technology has steadily been increasing to age 50 and beyond, potentially pushing the boundaries of what may be considered a safe age for pregnancy. Because pregnancies in this age range are not well studied, our objective was to describe the rates of adverse pregnancy outcomes of patients age 50 and older and compare them to previously reported rates of outcomes in advanced maternal age (AMA) patients age ≥ 35 and < 50 years. 

Study Design: This is a retrospective observation study describing maternal and neonatal outcomes of pregnancy ≥ age 50 from 2019 – 2024 at our institution. The rates of adverse pregnancy outcomes were compared to previously reported outcome data from large meta-analyses of AMA pregnancy ≥ 35 and < 50 years. Demographic factors, pregnancy and neonatal outcomes were obtained from medical records.

Results: 15 patients were included with a total of 14 live births.   Median gestational age at conception was 51 years old, with an age range from 51-65 years.  Compared to previously reported outcome data of pregnancies in patients ≥ 35 and < 50 years, there was a statistically significant increase in the rate of hypertensive disorders of pregnancy (26.7% vs. 3.1%; p-value < 0.001) and cesarean delivery (73.3% vs 28.7%; p-value < 0.001). Rates of NICU admission and preterm birth were also increased, but not significantly different among the two groups.

Conclusion: There was an increased risk of some adverse pregnancy in patients age 50 or above compared to AMA p</span>atients younger than 50. Due to the rarity of these pregnancies, evidenced-based protocols to optimize pregnancy outcomes in postmenopausal patients have not yet been developed. Patients planning pregnancy at age 50 or later should be strongly cautioned about the increased risk of adverse outcomes, and alternative options should be considered.