akusherstvoObstetrics, Gynecology and ReproductionАкушерство, Гинекология и Репродукция2313-73472500-3194IRBIS LLC10.17749/2313-7347/ob.gyn.rep.2021.231akusherstvo-1068Research ArticleREVIEW ARTICLESНАУЧНЫЕ ОБЗОРЫPregnancy in advanced age of mothers and fathersБеременность в пожилом возрасте матерей и отцовДадакК.DadakC.

Дадак Кристиан – доктор медицинских наук, профессор кафедры акушерства и гинекологии, отделение общей гинекологии и гинекологической онкологии.

Вена.

Scopus Author ID: 7003466206.

Christian Dadak - Dr Sci Med, Professor, Department of Obstetrics and Gynecology, Division of General Gynecology and Gynecologic Oncology, Medical University of Vienna.

Vienna.

Scopus Author ID: 7003466206.

christian.dadak@meduniwien.ac.atВенский медицинский университетАвстрияMedical University of ViennaAustria202109092021154415418Copyright © Dadak C., 20212021Дадак К.Dadak C.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gynecology.su/jour/article/view/1068

There is a higher incidence of infertility, chromosomal aberrations, poor results of in vitro fertilization, ectopic pregnancies, spontaneous abortion, preeclampsia, placenta previa, gestational diabetes mellitus, caesarean section, chronic diseases with higher rates of admission into intensive care units, and a higher rate of maternal mortality among women who delay pregnancy into advanced age. This is mainly due to socioeconomic causes as well as the increased use of contraceptives. Problems due to advanced maternal age arise also with egg donations. Only chromosome aberrations are related to the age of the donor. Paternal age also appears to play a significant role in the outcome of the pregnancy. However, opinions vary in the literature available. Counseling the couples should be addressed.

Среди женщин, отложивших беременность до более старшего возраста, наблюдается более высокая частота бесплодия, хромосомных аберраций, неудач экстракорпорального оплодотворения, внематочной беременности, самопроизвольных абортов, преэклампсии, предлежания плаценты, гестационного сахарного диабета, операций кесарева сечения, хронических заболеваний с более высокой частотой госпитализации в отделения интенсивной терапии и более высокой частотой материнской смертности. В основном это связано с социально-экономическими причинами, а также с ростом использования противозачаточных средств. Проблемы из-за преклонного возраста матери возникают и с донорством яйцеклеток: с возрастом донора связаны хромосомные аберрации. Возраст отца также играет важную роль в исходе беременности. Впрочем, имеющиеся в доступной литературе мнения различаются. Следует рекомендовать консультирование семейных пар.

беременностьпожилой возраст материпожилой возраст отцаpregnancyadvanced maternal ageadvanced paternal ageReferencesStatistik Austria, 2015. Available at: http://statistik.at/web_de/statistiken/index.html.Statistik Austria, 2015. Available at: http://statistik.at/web_de/statistiken/index.html.Fretts R.C. Management of pregnancy in women of advanced age. UpToDate, 2017. Available at: https://www.uptodate.com/contents/management-of-pregnancy-in-women-of-advanced-age.Fretts R.C. Management of pregnancy in women of advanced age. UpToDate, 2017. Available at: https://www.uptodate.com/contents/management-of-pregnancy-in-women-of-advanced-age.Rille-Pfeiffer Ch. Osterreichisches Institut fur Familienforschung. Univ Wien: pers Mitteilung, 2017.Rille-Pfeiffer Ch. Osterreichisches Institut fur Familienforschung. Univ Wien: pers Mitteilung, 2017.Assisted Reproductive Technology. National Summary Report. Centers for Disease Control and Prevention, 2014. 78 p. Available at: https://www.cdc.gov/art/pdf/2014-report/art-2014-national-summary-report.pdf.Assisted Reproductive Technology. National Summary Report. Centers for Disease Control and Prevention, 2014. 78 p. Available at: https://www.cdc.gov/art/pdf/2014-report/art-2014-national-summary-report.pdf.Yeh J.S., Steward R.G., Dude A.M. et al. Pregnancy rates in donor oocytes cycles compared to similar autologous in vitro fertilization cycles: an analyses of 26,457 fresh cycles from the Society for Assisted Reproductive Technology. Fertil Steril. 2014;102(2):399-404. https://doi.org/10.1016/j.fertnstert.2014.04.027.Yeh J.S., Steward R.G., Dude A.M. et al. Pregnancy rates in donor oocytes cycles compared to similar autologous in vitro fertilization cycles: an analyses of 26,457 fresh cycles from the Society for Assisted Reproductive Technology. Fertil Steril. 2014;102(2):399-404. https://doi.org/10.1016/j.fertnstert.2014.04.027.Balasch J., Gratacos E. Delayed childbearing: effects on fertility and the outcome of pregnancy. Curr Opin Obstet Gyn. 2012;24(3):187-93. https://doi.org/10.1097/GCO.0b013e3283517908.Balasch J., Gratacos E. Delayed childbearing: effects on fertility and the outcome of pregnancy. Curr Opin Obstet Gyn. 2012;24(3):187-93. https://doi.org/10.1097/GCO.0b013e3283517908.Schreinemachers D.M., Cross P.K., Hook E.B. Rates of trisomies 21, 18, 13 and other chromosome abnormalities in about 20 000 prenatal studies compared with estimated rates in live births. Hum Genet. 1982;61(4):318-24. https://doi.org/10.1007/BF00276595.Schreinemachers D.M., Cross P.K., Hook E.B. Rates of trisomies 21, 18, 13 and other chromosome abnormalities in about 20 000 prenatal studies compared with estimated rates in live births. Hum Genet. 1982;61(4):318-24. https://doi.org/10.1007/BF00276595.NIPT/Cell Free DNA Screening. Available at: http://perinatalquality.org/2016.NIPT/Cell Free DNA Screening. Available at: http://perinatalquality.org/2016.Yogev Y., Melamed N., Bardin R. et al. Pregnancy outcome at extremely advanced maternal age. Am J Obstet Gynecol. 2010;203(6):558e.1-7. https://doi.org/10.1016/j.ajog.2010.07.039.Yogev Y., Melamed N., Bardin R. et al. Pregnancy outcome at extremely advanced maternal age. Am J Obstet Gynecol. 2010;203(6):558e.1-7. https://doi.org/10.1016/j.ajog.2010.07.039.Paulson R.J., Boostanfar R., Saadat P. et al. Pregnancy in the sixth decade of life: obstetric outcomes in women of advanced reproductive age. JAMA. 2002;288(18):2320-3. https://doi.org/10.1001/jama.288.18.2320.Paulson R.J., Boostanfar R., Saadat P. et al. Pregnancy in the sixth decade of life: obstetric outcomes in women of advanced reproductive age. JAMA. 2002;288(18):2320-3. https://doi.org/10.1001/jama.288.18.2320.Gilbert W.M., Nesbitt T.S., Danielsen B. Childbearing beyond age 40: pregnancy outcome in 24,032 cases. Obstet Gynecol. 1999;93(1):9-14. https://doi.org/10.1016/s0029-7844(98)00382-2.Gilbert W.M., Nesbitt T.S., Danielsen B. Childbearing beyond age 40: pregnancy outcome in 24,032 cases. Obstet Gynecol. 1999;93(1):9-14. https://doi.org/10.1016/s0029-7844(98)00382-2.Jacobsson B., Ladfors L., Milsom I. Advanced maternal age and adverse perinatal outcome. Obstet Gynecol. 2004;104(4):727-33. https://doi.org/10.1097/01.AOG.0000140682.63746.be.Jacobsson B., Ladfors L., Milsom I. Advanced maternal age and adverse perinatal outcome. Obstet Gynecol. 2004;104(4):727-33. https://doi.org/10.1097/01.AOG.0000140682.63746.be.Haslinger C., Stoiber B., Capanna F. et al. Postponed pregnancies and risks of very advanced maternal age. Swiss Med Wkly. 2016;146:w14330. https://doi.org/10.4414/smw.2016.14330.Haslinger C., Stoiber B., Capanna F. et al. Postponed pregnancies and risks of very advanced maternal age. Swiss Med Wkly. 2016;146:w14330. https://doi.org/10.4414/smw.2016.14330.Fitzpatrick K.E., Tuffnell D., Kurinczuk J.J., Knight M. Pregnancy at very advanced maternal age: a UK population-based cohort study. BJOG. 2017;124(7):1097-106. https://doi.org/10.1111/1471-0528.14269.Fitzpatrick K.E., Tuffnell D., Kurinczuk J.J., Knight M. Pregnancy at very advanced maternal age: a UK population-based cohort study. BJOG. 2017;124(7):1097-106. https://doi.org/10.1111/1471-0528.14269.Richards M.K., Flanagan M.R., Littman A.J. et al. Primary cesarean section and adverse delivery outcomes among women of very advanced maternal age. J Perinatol. 2016;36(4):272-7. https://doi.org/10.1038/jp.2015.204.Richards M.K., Flanagan M.R., Littman A.J. et al. Primary cesarean section and adverse delivery outcomes among women of very advanced maternal age. J Perinatol. 2016;36(4):272-7. https://doi.org/10.1038/jp.2015.204.Reddy U.M., Ko C.W., Willinger M. Maternal age and the risk of stillbirth throughout pregnancy in the United States. Am J Obstet Gynecol. 2006;195:764-70. https://doi.org/10.1016/j.ajog.2006.06.019.Reddy U.M., Ko C.W., Willinger M. Maternal age and the risk of stillbirth throughout pregnancy in the United States. Am J Obstet Gynecol. 2006;195:764-70. https://doi.org/10.1016/j.ajog.2006.06.019.Berg C.J., Callaghan W.M., Syverson C., Henderson Z. Pregnancy-related mortality in the United States, 1998 to 2005. Obstet Gynecol. 2010;116(6):1302-9. https://doi.org/10.1097/AOG.0b013e3181fdfb11.Berg C.J., Callaghan W.M., Syverson C., Henderson Z. Pregnancy-related mortality in the United States, 1998 to 2005. Obstet Gynecol. 2010;116(6):1302-9. https://doi.org/10.1097/AOG.0b013e3181fdfb11.Crosnoe L.E., Kim E.D. Impact of age on male fertility. Curr Opin Obstet Gynecol. 2013;25(3):181-5. https://doi.org/10.1097/GCO.0b013e32836024cb.Crosnoe L.E., Kim E.D. Impact of age on male fertility. Curr Opin Obstet Gynecol. 2013;25(3):181-5. https://doi.org/10.1097/GCO.0b013e32836024cb.Ford W.C., North K., Taylor H. et al. Increasing paternal age is associated with delayed conception in a large population of fertile couples: evidence for declining fecundity in older men. The ALSPAC Study Team (Avon Longitudinal Study of Pregnancy and Childhood). Hum Reprod. 2000;15(8):1703-8. https://doi.org/10.1093/humrep/15.8.1703.Ford W.C., North K., Taylor H. et al. Increasing paternal age is associated with delayed conception in a large population of fertile couples: evidence for declining fecundity in older men. The ALSPAC Study Team (Avon Longitudinal Study of Pregnancy and Childhood). Hum Reprod. 2000;15(8):1703-8. https://doi.org/10.1093/humrep/15.8.1703.Ramasamy R., Chiba K., Butler P., Lamb D.J. Male biological clock: a critical analysis of advanced paternal age. Fertil Steril. 2015;103(6):1402-6. https://doi.org/10.1016/j.fertnstert.2015.03.011.Ramasamy R., Chiba K., Butler P., Lamb D.J. Male biological clock: a critical analysis of advanced paternal age. Fertil Steril. 2015;103(6):1402-6. https://doi.org/10.1016/j.fertnstert.2015.03.011.Hatch M., Kline J., Levin B. et al. Paternal age and trisomy among spontaneous abortions. Hum Genet. 1990;85(3):355-61. https://doi.org/10.1007/BF00206761.Hatch M., Kline J., Levin B. et al. Paternal age and trisomy among spontaneous abortions. Hum Genet. 1990;85(3):355-61. https://doi.org/10.1007/BF00206761.Mathieu C., Ecochard R., Bied V. et al. Cumulative conception rate following intrauterine artificial insemination with husband's spermatozoa: influence of husband's age. Hum Reprod. 1995;10(5):1090-7. https://doi.org/10.1093/oxfordjournals.humrep.a136100.Mathieu C., Ecochard R., Bied V. et al. Cumulative conception rate following intrauterine artificial insemination with husband's spermatozoa: influence of husband's age. Hum Reprod. 1995;10(5):1090-7. https://doi.org/10.1093/oxfordjournals.humrep.a136100.Slama R., Werwatz A., Boutou O. et al. Does male age affect the risk pf spontaneous abortion? An approach using semiparametric regression. Am J Epidemiol. 2003;157(9):815-24. https://doi.org/10.1093/aje/kwg056.Slama R., Werwatz A., Boutou O. et al. Does male age affect the risk pf spontaneous abortion? An approach using semiparametric regression. Am J Epidemiol. 2003;157(9):815-24. https://doi.org/10.1093/aje/kwg056.Olshan A.F., Ananth C.V., Savitz D.A. Intrauterine growth retardation as an endpoint in mutation epidemiology: an evaluation based on paternal age. Mutat Res. 1995; 344(1-2):89-94. https://doi.org/10.1016/0165-1218(95)90043-8.Olshan A.F., Ananth C.V., Savitz D.A. Intrauterine growth retardation as an endpoint in mutation epidemiology: an evaluation based on paternal age. Mutat Res. 1995; 344(1-2):89-94. https://doi.org/10.1016/0165-1218(95)90043-8.Shah P.S. Knowledge Synthesis Group on determinants of preterm/low birthweight births. Paternal factors and low birth weight, preterm, and small for gestational age births: a systematic review. Am J Obstet Gynecol. 2010; 202(2):103-23. https://doi.org/10.1016/j.ajog.2009.08.026.Shah P.S. Knowledge Synthesis Group on determinants of preterm/low birthweight births. Paternal factors and low birth weight, preterm, and small for gestational age births: a systematic review. Am J Obstet Gynecol. 2010; 202(2):103-23. https://doi.org/10.1016/j.ajog.2009.08.026.Chen X.K., Wen S.W., Krewski D. et al. Paternal age and adverse birth outcomes: teenager or 40+, who is at risk? Hum Reprod. 2008; 23(6):1290-6. https://doi.org/10.1093/humrep/dem403.Chen X.K., Wen S.W., Krewski D. et al. Paternal age and adverse birth outcomes: teenager or 40+, who is at risk? Hum Reprod. 2008; 23(6):1290-6. https://doi.org/10.1093/humrep/dem403.Saha S., Barnett A.G., Foldi C. et al. Advanced paternal age is associated with impaired neurocognitive outcomes during infancy and childhood. PLoS Med. 2009;6(3):e40. https://doi.org/10.1371/journal.pmed.1000040.Saha S., Barnett A.G., Foldi C. et al. Advanced paternal age is associated with impaired neurocognitive outcomes during infancy and childhood. PLoS Med. 2009;6(3):e40. https://doi.org/10.1371/journal.pmed.1000040.Myrskyla M., Silventoinen K., Tynelius P., Rasmussen F. Is later better or worse? Association of advanced parental age with offspring cognitive ability among half a million young Swedish men. Am J Epidemiol. 2013;177(7):649-55. https://doi.org/10.1093/aje/kws237.Myrskyla M., Silventoinen K., Tynelius P., Rasmussen F. Is later better or worse? Association of advanced parental age with offspring cognitive ability among half a million young Swedish men. Am J Epidemiol. 2013;177(7):649-55. https://doi.org/10.1093/aje/kws237.Reichenberg A., Gross R., Weiser M. et al. Advancing paternal age and autism. Arch Gen Psychiatry. 2006;63(9):1026-32. https://doi.org/10.1001/archpsyc.63.9.1026.Reichenberg A., Gross R., Weiser M. et al. Advancing paternal age and autism. Arch Gen Psychiatry. 2006;63(9):1026-32. https://doi.org/10.1001/archpsyc.63.9.1026.

The authors declare that there are no conflicts of interest present.