TY - JOUR
T1 - Increasing maternal age at first pregnancy planning
T2 - Health outcomes and associated costs
AU - Tromp, M.
AU - Ravelli, A. C.J.
AU - Reitsma, J. B.
AU - Bonsel, G. J.
AU - Mol, B. W.
PY - 2011/12/1
Y1 - 2011/12/1
N2 - Objectives: To describe the consequences in terms of health outcomes, care and associated healthcare costs for three hypothetical cohorts of women planning their first pregnancy at a fixed, different age. Design: Decision model based on data from perinatal registries and the literature. Setting: The Netherlands. Population: 3 hypothetical cohorts of 100 000 women aged 23, 29 and 36 years, planning a first pregnancy. Main outcome measures: Live birth, pregnancy complications for mother and child and associated healthcare costs. Results: For the three cohorts of 23-, 29- and 36-yearold women, 1.6%, 4.6% and 14% of women would not succeed in an ongoing pregnancy (spontaneous or after assisted reproductive technology). The cohort aged 36 gave 9% more miscarriages, 8% more fertility treatment and 1.4% more multiple births than the cohort aged 29. The proportion of caesarean sections among low risk women was 4.9% and 11% higher respectively for the cohorts aged 29 and 36, compared with the cohort aged 23 at start. Eventually, 98%, 95% and 85% of the women in each of the three cohorts gave live birth. The costs for the two older cohorts were €415 and €1662 higher per ongoing pregnancy than the cohort aged 23 years. Conclusions: Spontaneous conception and mode of delivery are most susceptible to increasing maternal age leading to involuntary childlessness and non-spontaneous labour. The increase in assisted reproduction technology, twin pregnancies and delivery complications results in higher costs along with fewer ongoing pregnancies at higher age.
AB - Objectives: To describe the consequences in terms of health outcomes, care and associated healthcare costs for three hypothetical cohorts of women planning their first pregnancy at a fixed, different age. Design: Decision model based on data from perinatal registries and the literature. Setting: The Netherlands. Population: 3 hypothetical cohorts of 100 000 women aged 23, 29 and 36 years, planning a first pregnancy. Main outcome measures: Live birth, pregnancy complications for mother and child and associated healthcare costs. Results: For the three cohorts of 23-, 29- and 36-yearold women, 1.6%, 4.6% and 14% of women would not succeed in an ongoing pregnancy (spontaneous or after assisted reproductive technology). The cohort aged 36 gave 9% more miscarriages, 8% more fertility treatment and 1.4% more multiple births than the cohort aged 29. The proportion of caesarean sections among low risk women was 4.9% and 11% higher respectively for the cohorts aged 29 and 36, compared with the cohort aged 23 at start. Eventually, 98%, 95% and 85% of the women in each of the three cohorts gave live birth. The costs for the two older cohorts were €415 and €1662 higher per ongoing pregnancy than the cohort aged 23 years. Conclusions: Spontaneous conception and mode of delivery are most susceptible to increasing maternal age leading to involuntary childlessness and non-spontaneous labour. The increase in assisted reproduction technology, twin pregnancies and delivery complications results in higher costs along with fewer ongoing pregnancies at higher age.
UR - http://www.scopus.com/inward/record.url?scp=84855999415&partnerID=8YFLogxK
U2 - 10.1136/jech.2009.095422
DO - 10.1136/jech.2009.095422
M3 - Article
C2 - 20709858
AN - SCOPUS:84855999415
SN - 0143-005X
VL - 65
SP - 1083
EP - 1090
JO - Journal of Epidemiology and Community Health
JF - Journal of Epidemiology and Community Health
IS - 12
ER -