The effect of advanced maternal age and gestational weight gain on newborns

Yazan Arslan, Ayse; Ardic, Cüneyt; Kara Esen, Beril

doi:10.1590/1806-9282.20240961

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Original Article • Rev. Assoc. Med. Bras. 71 (2) • 2025 • https://doi.org/10.1590/1806-9282.20240961 linkcopy

The effect of advanced maternal age and gestational weight gain on newborns

Authorship SCIMAGO INSTITUTIONS RANKINGS

INTRODUCTION: Advanced maternal age is defined as the mother being ≥35 years of age at the time of birth. Gestational weight gain is the difference between the weight measurements of the pregnant woman at prenatal follow-up just before birth and at pre-conception or at the beginning of the first trimester. In our study, we examined the effects of maternal age and gestational weight gain on neonatal outcomes.

METHODS: This study was conducted, in the Rize province between April 2022 and January 2023, on pregnant women registered in seven Family Health Centers in the last 5 years and their resulting newborns. In total, this study analyzed the data of 642 pregnant women and their 642 newborns. Data records in the study are pregnant-puerperal follow-up form, newborn-child follow-up form, and family medicine information system.

RESULTS: The probability of newborns of mothers with excessive gestational weight gain being large-for-gestational-age was found to be 1.81 times higher in univariate analysis and 1.72 times higher in multivariate analysis. While the effect of gestational weight gain status on birth weight Z-score was significant, gestational age had no significant effect (p=0.001 and p=0.136, respectively).

CONCLUSION: In this period, when obesity, which is a disease of our age, is widespread and the gestational age has moved to older ages, there is a need for more extensive research on this subject in future studies.

KEYWORDS:
Maternal age; Gestational weight gain; Large for gestational age

		Inadequate			Adequate			Excessive
		(n=173)		p	(n=233)		p	(n=236)		p
		<35	≥35		<35	≥35		<35	≥35
Maternal characteristics		n=84	n=89		n=121	n=112		n=117	n=119
Parity	Primipara	26 (31)	8 (9)	<0.001 *	44 (36.4)	13 (11.6)	<0.001 *	40 (34.2)	11 (9.2)	<0.001 *
Parity	Primary-Secondary	23 (27.4)	39 (43.8)	0.031 *	36 (29.8)	46 (41.4)	0.176*	26 (22.2)^a	53 (44.9)^b	0.001 *
Education	High School	25 (29.8)	27 (30.3)		37 (30.6)	29 (26.1)		40 (34.2)^a	31 (26.3)^a
Education	University	36 (42.9)	23 (25.8)		48 (39.7)	36 (32.4)		51 (43.6)^a	34 (28.8)^b
Smoking status	Smoker	1 (1.2)	5 (5.6)	0.112**	11 (9.1)	2 (1.8)	0.015 **	8 (6.8)	9 (7.6)	0.829*
Infant characteristics		n=84	n=89		n=121	n=112		n=117	n=119
Gender	Female	38 (45.2)	47 (52.8)	0.319*	61 (50.4)	51 (45.5)	0.457*	50 (42.7)	57 (47.9)	0.426*
Birth Time	Preterm	14 (16.7)	23 (25.8)	0.141*	14 (107)	19 (17)	0.238*	12 (10.3)	17 (14.3)	0.346*
Birth Time	SGA	3 (3.6)	3 (3.4)	0.533**	3 (2.5)	4 (3.6)	0.213**	3 (2.6)	5 (4.2)	0.849**
Fetal	AGA	70 (83.3)	69 (77.5)		103 (85.1)	85 (75.9)		83 (70.9)	84 (70.6)
Growth	LGA	11 (13.1)	17 (19.1)		15 (12.4)	23 (20.5)		31 (26.5)	30 (25.2)
Growth	<2500	0	6 (6.7)	0.046**	4 (3.3)	2 (1.8)	0.352**	1 (0.9)	2 (1.7)	0.089**
Birth	2500-4000	80 (95.2)	79 (88.8)		110 (90.9)	98 (87.5)		96 (82.1)	107 (89.9)
Weight	>4000	4 (4.8)	4 (4.5)		7 (5.8)	12 (10.7)		20 (17.1)	10 (8.4)

		Preterm			LGA
		n (%)	Crude	Adjusteda	n (%)	Crude	Adjustedb
		n (%)	OR (95% CI)	OR (95% CI)	n (%)	OR (95% CI)	OR (95% CI)
Variables
Age	<35	40 (40.4)	Ref. (1)	Ref. (1)	57 (44.9)	Ref. (1)	Ref. (1)
	≥35	59 (59.6)	1.6 (1.04–2.47)	1.34 (0.82–2.20)	70 (55.1)	1.32 (0.89–1.95)	1.27 (0.81–1.98)
	Adequate	37 (37.4)	Ref. (1)	Ref. (1)	28 (22)	Ref. (1)	Ref. (1)
GWG	Inadequate	33 (33.3)	1.64 (0.98–2.75)	1.65 (0.98–2.8)	38 (29.9)	0.997 (0.58–1.70)	0.94 (0.55–1.62)
GWG	Excessive	29 (29.3)	0.85 (0.5–1.44)	0.80 (0.47–1.38)	61 (48)	1.81 (1.15–2.85)	1.72 (1.08–2.74)

		Birth weight Z-score	p-value	Birth length Z-score	p-value	Birth head circumference Z-score	p-value
Age	<35	0.42±0.92	0.136*	0.38±089	<0.001 *	1.01±0.96	0.326*
Age	≥35	0.53±1		0.64±0.92		1.08±1.04
GWG	Inadequate (n=173)	0.31±0.96^a	0.001 **	0.39±0.92^a	0.004 **	0.97±1.03	0.303**
	Adequate (n=233)	0.41±0.92^a		0.44±0.88^a		1.02±1
	Excessive (n=236)	0.66±0.97^b		0.66±0.93^b		1.12±0.98

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[TFN1] ^*
Chi-squared test,

[TFN2] ^**
Fisher's exact test.

[TFN2a] GWG: gestational weight gain; SGA: small-for-age; AGA: gestational-age-appropriate; LGA: large-for-gestational-age. Same superscript letter denotes a subset of categories whose column value do not differ significantly form each other at the 0.05 level.