Advanced Maternal Age Contribute to Complications During Pregnancy - Research Paper Example

? Advanced Maternal Age Contribute to Complications during Pregnancy Advanced Maternal Age Contribute to Complications during Pregnancy INTRODUCTION There has been an increase in the number of childbearing among the old mothers in United States, whereby the birth rates are among aged thirty-five and forty-four years. Therefore, as women have continued to delay childbearing, they increase the risk of fetal morbidity and mortality among the age group. Researchers have indicated the mature gravidas are at a high risk of negative birth results, which ranges from low births weight, preterm, small size for gestational age and fetal mortality to stillbirth (Robb, Alder & Prescott, 2005, p. 135). There is a connection between advanced maternal age and stillbirths, which has been documented, though there is little information on timing of the utero fetal mortality (Benzie, 2008, p. 183). An analysis of more than five million singleton deliveries was aimed at determining the peak risk period for stillbirths among the older mothers between the age of thirty-seven and forty-one. Other studies have assessed the differential risk associated with stillbirths before labor or during labor, in order to understand the relationship, which results to tailored invention strategies focused on decreasing utero fetal problems among old mothers. Nevertheless, the paper will focus on discussing complications during pregnancy, which are associated with Advanced Maternal Age. Advance Maternal Age refers to the childbearing woman, who is over the age of thirty-five, and it is considered as relatively more hazardous from both maternal and fetal dimensions. AMA is conventionally defined as the age, which is greater than thirty-five at the time of delivery, while the modern definition refers to the Very Advanced Maternal Age, which is considered the age that is greater than or equal to the forty five at the time of delivery (King, Fountain, Dakhlallah & Bearman, 2009, p. 1678). Moreover, according to designation of AMA a woman’s fertility decreases after the age of thirty-five. In fact, one third of the women with delayed pregnancy to their mid-thirties and beyond have difficulties during delivery or physical maternal or fetal complications. In addition, these women may undergo an increased incidence of miscarriage or stillbirths, which leads to emotional and psychological trauma (Ayers, 2001, p. 91). LITERATURE REVIEW Factors Influencing women’s decision of timing Motherhood One of the factors influencing the a woman’s decision is independence, whereby a woman is more likely to makes a decision of conceiving later in her life, compared to a woman who has children earlier in order to stress the significance of independence through education, employment, and financial stability. Moreover, the readiness is also a factor that can influence a woman to delay in child bearing, since they have to feel ready for motherhood due to satisfactions of their personal goals (Byrom, 2004, p. 779). The other factor relates to the projection of their life plan, whereby they have a recurring theme of all ages with or without children, and this is projected through a metal plan for their life, which is integrated with their intentions of childbearing. The other factor relates to the biological clock, which has an impact on the decline fertility on decision concerning childbearing as a recurring theme for women at the age above thirty years. The other factor is the rates of divorce, whereby women make decision concerning timing of motherhood under the influence of their knowledge concerning the current rates of divorce in the community. The other factor relates to stability of a relationship, since it is vital to women who are not willing to raise a child on their own. In fact, numerous women have case of failed long-term relationship, like marriage (Cunningham, Rivera, & Spence, 2011, p. 249). Therefore, before establishing a stable relationship, women are not deemed suitable for childbearing and childrearing. The other factor relates to partner readiness, whereby they make a decision of starting a family through a mutual negotiation with male partner. Financial stability in the family is a factor, which is considered a recurring theme for women in their old age group. The other factor relates to the family origin, whereby a woman acknowledges that they have more choices compared to other mother in the generation concerning childbearing. In this case, there is a difference in raising children in various family origins (Delpisheh, Brabin, Attia & Brabin, 2006, p. 965). Nowadays, families are more geographically distant compared to the past, whereby some younger women are forced to wait without children in order to start a family after achieving their career and financial objectives, hence move closer to their family of origin for childbearing support. Risk of Antepartum and Intrapartum Stillbirth Women bearing children after the age of thirty-five, increase the chance of total stillbirths, intrapartum stillbirth and antepartum, whereby there is uniformity related to effects of these conditions (Mcintyre, Newburn-Cook, O’brien & Demianczuk, 2009, p. 670). Moreover, in the oldest maternal group, which is at the age of forty, there is one hundred percent chance of antepartum stillbirth that is greater than intrapartum stillbirth is. However, there is confidence relating to the intervals for two-point estimates that are overlapped due to the relative paucity of results of intrapartum stillbirth. In fact, the magnitude of the differences is appreciable with a significant trend, thus with this expectations of these results being presented, there is a chance for evaluating the risk related to maternal age during the antenatal duration than delivery (Hamisu, Ronee, Alio & Kirby, 2008, p. 843). There other possible explanation that concerns frequency of pregnancy-related conditions with increased maternal age, whereby the population rates for diabetes, chronic hypertension and placental pathologies are cases in older mothers. Therefore, excess levels of obstetric complications among the older mother can contribute to the increased risk for antepartum and intrapartum stillbirth. In fact, there is analysis aimed at adjusting for pregnancy complications after detection and estimation of resultant risk (Loke & Poon, 2011, p. 1150). Therefore, information on complications related are made routinely available, though the restriction in the analysis in this period can result to case of intrapartum stillbirth, with mothers instability of the estimates. The Risk of Cesarean Birth The other complication relates to the risk of cesarean birth among women at advanced maternal age, whereby cases of singleton pregnancies in developed countries for older women are 1.39 times higher than the younger women do (Bayrampour & Heaman, 2010, p. 219). Therefore, the risk of cesarean birth has been advancing with age, since proportion of women, delaying childbearing is rising thus resulting to increased cesarean delivery rate. Other reasons for high cesarean rate among women in adverse maternal age, is associated with inefficiencies of aging myometrium incompetency, which is intergrated with lack of previous labor induced gap junction and reduced number of oxytocin receptors. In this case, there is a possibility of physiological factors related to increased rate of cesarean, hence increasing risk of cesarean birth among nulliparas due to dystocia (Jolly, Sebire & Harris, 2000, p. 2437). Moreover, age related dystocia is corrected by the arguments of oxytocin, whereby in most cases it results to a more accurate and universal definition of dystocia and effort of investigating its rate among women at advanced maternal age in relation to cesarean birth (Treacy, Robson & O’Herlihy, 2006, p. 760). On the other hand, there is an increased rate of chronic medical diseases and certainty in maternal complications like gestational diabetes and preeclampsia among women in advanced maternal age, who contributes to higher rates of cesarean births. The other issue relates to the use of anesthesia during the cesarean birth associated with the advanced maternal age in a vaginal delivery. This reduces the effort of pushing, pregnancy complication, decreased pelvic complications, increased rate of macrosomia among these women higher pre-pregnancy BMI, and medical-legal concerns. Risk Factor for Preterm Birth and Fetal Growth Restriction Delayed childbearing increases the risk of preterm birth and fetal growth, whereby the restrictions of growth are vital because of the number of first births to women in their age of mid-thirties. Availability and increase in the use of vitro fertilization and other technologies for reproduction has enabled women to delay child bearing to the end of their reproductive cycle (Carolan, 2005, p. 764). Therefore, the increase in preterm birth rate has advanced the high risk associated with obstetrical care and the program of preventing preterm. In this case, the preterm birth is a significant public health issue since it is considered a major determinant of neonatal mortality, and morbidity of infants and children. There are factors contributing to increased rate of preterm birth, which entails an increase maternal age, and use of ovarian stimulation, vitro fertilization and increased multiple gestation pregnancies. Moreover, the effects of age on both the gestation age and birth weight is consistent across the different studies that associates the order maternal age with increased prevalence of preexisting chronic illness, medical problems during pregnancies, and complication of antepartum and labor (Hammarberg & Clarke, 2005, p. 187). The studies also indicate that the reproductive efficiency related delay of conception, reduced viability of embryo and trisomic conception, has reduced the function of increasing maternal age. RESEARCH HYPOTHESIS 1. The risk factors related to advanced maternal age for reduced in utero fetal survival. 2. Rise in the risk for compromising utero fetal survival associated positively with maternal age in a dose-dependent model. 3. Sensitive risk related with maternal age varies for antepartum versus intrapartum stillbirth. RESEARCH METHOD The research will apply qualitative measures of data analysis, which will be collected through questionnaires as the techniques of data collection. The participants will be randomly selected and they will be provided with open-ended questions. There will a consent form issued to the participants, in order for them to understand the purpose of the research and to sign. Privacy and confidentiality of information collected from the respondents in the research will be maintained. CONCLUSION In conclusion, the paper has explored issues related to complications experienced by advanced maternal age, which contribute to complications during pregnancy. The paper has defined the term Advanced Maternal Age (AMA), in order to provide a basis of understanding the complications associated with delayed child bearing. The factors influencing women’s decision of timing motherhood has been explored and several conditions have been discussed as the complications relate to delayed pregnancies, and this contributes to achieving the set objective of the paper. References Ayers, S. (2001), Assessing psychopathology in pregnancy and postpartum, Journal of Psychosomatic Obstetrics and Gynecology, 22, 91–102. Bayrampour, H. & Heaman, M. (2010), Advanced Maternal Age and the Risk of Cesarean Birth: A Systematic Review, Birth, 37:3: 219-225  Benzie, K. (2008), Advanced maternal age: Are decisions about the timing of child-bearing a failure to understand the risks? Commentary. Canadian Medical Association, 178 (2): 183-184   Byrom, A. (2004), Advanced maternal age: a literature review, Advanced Maternal Age, British Journal of Iwid wifery, 12(12): 779-783   Carolan, M. (2005), “Doing It Properly”: The Experience of First Mothering Over 35 Years, Health Care for Women International, 26:764–787 Cunningham, C. 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