Actions for ADVANCED MATERNAL AGE AND PREGNANCY OUTCOME: A CRITICAL APPRAISAL OF THE SCIENTIFIC LITERATURE

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ADVANCED MATERNAL AGE AND PREGNANCY OUTCOME: A CRITICAL APPRAISAL OF THE SCIENTIFIC LITERATURE

Author
Mansfield, Phyllis Kernoff
Physical Description
290 pages
Additional Creators
Pennsylvania State University
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Summary
More and more American women are postponing their childbearing. Yet the guidelines they seek about the medical risks of late-timed pregnancy are contradictory. On the one hand, medical opinion has declared pregnancy after 35 to be risky; on the other hand, current popular opinion documents safe childbearing for this cohort of older women.
This research was undertaken as an attempt to reconcile these discrepant views. It was hypothesized, first, that the scientific literature on this subject has reached erroneous conclusions because of serious methodological flaws, and, second, that the conditions surrounding late-timed pregnancy in past decades were less favorable than the circumstances of contemporary older women, thereby suggesting a favorable prognosis for today's postponers.
Both hypotheses were supported. Of the 104 studies performed in the United States of advanced maternal age and eight pregnancy outcomes, only 10 percent were determined to be methodologically sound. Moreover, as the methodologies improved, fewer and fewer studies found an age effect at all. Additionally, it was observed that the particular circumstances surrounding late-timed pregnancy in the past (the altered medical management of older women, a history of infertility, an unplanned pregnancy late in life, a high-parity birth) all could explain the adverse outcomes sometimes found without relying on an explanation based on biological aging. The lack of evidence for morphological reproductive changes in women aged 30-40 also supported this view. In light of the favorable circumstances surrounding postponed childbearing today (healthier mothers, planned births, better health knowledge and behaviors), a favorable prognosis is offered to women who delay their childbearing.
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Dissertation Note
Ph.D. The Pennsylvania State University 1983.
Note
Source: Dissertation Abstracts International, Volume: 44-05, Section: A, page: 1343.
Part Of
Dissertation Abstracts International
44-05A
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