Impact of advanced maternal age on fecundity and women's and children's health

Objective.- There has been a consistent trend towards delayed childbearing in most Western countries. We present a review of the current epidemiological understanding of the effects of advanced maternal age on fecundity, maternal and child health. Materials and methods.- A narrative review of the literature based mostly on the key population-based studies on the subject. Results.- Delayed childbearing results in a substantial decrease in fecundity and a considerable increase in fetal loss; risk of the latter is doubled between 20-24 and 40-44 years of age. Other risks include those related to maternal health (maternal mortality and morbidity) and adverse pregnancy outcomes (multiple births, preterm delivery, fetal growth retardation and congenital anomalies). Conclusion.- Risks associated with delayed childbearing become significant for maternal age greater than 35 years, and are particularly high for women aged 40 years and greater Knowledge about the risks associated with advancing age can be helpful for couples in their decisions regarding childbearing. (c) 2008 Elsevier Masson SAS. Tous droits reserves.