Stephen Wood

and 1 more

Objective: The increased risk of antepartum stillbirth in mothers of Late Maternal Age (≥35 years of age) is well known. We sought to determine if this has changed over time. Design: Retrospective cohort study. Setting: The Canadian province of Alberta 1992-2019. Sample: All singleton births ≥23 weeks of gestation comprising 1,202,659 births with 3,749 antepartum stillbirths. Methods: Maternal age was categorized as <20, 20-34, 35-39 and ≥40 years of age and multivariate logistic regression analysis was performed. The fetus at risk approach was used to examine the risk of stillbirth by gestational age. An estimate of the optimal gestational age for delivery was calculated with a perinatal index. Year of birth was categorized by 1992-94, 1995-99, 2000-04, 2005-09, 2010-14, and 2015-19. Main outcome measures: Antepartum stillbirth, intrapartum stillbirth and neonatal death. Results: Compared to the baseline group of 20–34-year-old mothers, on adjusted analysis, both maternal age groups of 35-39 and ≥40 years were associated with antepartum stillbirth, odds ratio, 1.35; 95% confidence interval (1.23, 1.49) and odds ratio, 1.98; 95% confidence interval (1.67, 2.30). Over the study period we observed a decline in the rate for the 35–39-year-old age group from 5.1/1000 to 2.86/1000 and 5.1/1000 to 3.39/1000 for the ≥40-year-old group. Post dates delivery declined in both groups. Conclusions: Late maternal ae is independently associated with antepartum stillbirth. The risk has decreased over the study period due to a deliberate policy of earlier delivery at term.