Outcomes of multiple gestations with advanced maternal age

Objective. To investigate outcomes of twin gestations with advanced maternal age (AMA). Study design.Historical cohort of twin gestations cared for by a maternalfetal medicine faculty practice. Outcomes of patients with AMA (70) and non-AMA (75) were compared. AMA was defined as age ≥35. Analysis including mode of delivery, gestational age at delivery and overall complications was performed. Significance was determined using the chi-square test or the Student's t-test. Results.The Cesarean rate for AMA was significantly greater compared to non-AMA (80.0% vs. 54.7%; p=0.001). The main reason for the increased rate was uterine dysfunction. The mean gestational age at delivery for AMA was significantly greater than for non-AMA (36.7 weeks vs. 35.4 weeks; p= 0.02). There were no differences in rates of other adverse outcomes including gestational hypertension, pre-eclampsia, gestational diabetes, suspected fetal growth restriction, preterm birth, low birth weight or low birth weight percentiles. This remained true when we compared the 32 women ages ≥40 years to 118 women ages <40 years. Conclusion.Among twin pregnancies, AMA women are not at an increased risk of adverse pregnancy outcomes, aside from an increased rate of cesarean delivery.