Advanced maternal age and its association with placenta praevia and placental abruption: a meta-analysis
This study aimed to investigate the existence and magnitude of the association between advanced maternal age (AMA) and occurrence of placenta praevia (PP) and placental abruption (PA) among nulliparous and multiparous women, by a systematic review and meta-analysis. We searched articles published be...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz
2018-02-01
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| Series: | Cadernos de Saúde Pública |
| Subjects: | |
| Online Access: | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0102-311X2018000202001&lng=en&tlng=en |
| _version_ | 1811191931019984896 |
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| author | Katrini Guidolini Martinelli Érica Marvila Garcia Edson Theodoro dos Santos Neto Silvana Granado Nogueira da Gama |
| author_facet | Katrini Guidolini Martinelli Érica Marvila Garcia Edson Theodoro dos Santos Neto Silvana Granado Nogueira da Gama |
| author_sort | Katrini Guidolini Martinelli |
| collection | DOAJ |
| description | This study aimed to investigate the existence and magnitude of the association between advanced maternal age (AMA) and occurrence of placenta praevia (PP) and placental abruption (PA) among nulliparous and multiparous women, by a systematic review and meta-analysis. We searched articles published between January 1, 2005 and December 31, 2015, in any language, in the following databases: PubMed, Scopus, Web of Science, and LILACS. Women were grouped into two age categories: up to 34 years old and 35 years or older. The Newcastle-Ottawa Scale was used to evaluate the methodological quality of the studies. A meta-analysis was conducted for the PP and PA outcomes, using a meta-regression model to find possible covariates associated with heterogeneity among the studies and Egger’s test to assess publication bias. The protocol of this systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) system (CRD42016045594). Twenty-three studies met the criteria and were included in the meta-analysis. For both outcomes, an increase in age increased the magnitude of association strength, and PP (OR = 3.16, 95%CI: 2.79-3.57) was more strongly associated with AMA than PA (OR = 1.44, 95%CI: 1.35-1.54). For parity, there was no difference between nulliparous and multiparous women considered older for the PP and PA outcomes. Our review provided very low-quality evidence for both outcomes, since it encompasses observational studies with high statistical heterogeneity, diversity of populations, no control of confounding factors in several cases, and publication bias. However, the confidence intervals were small and there is a dose-response gradient, as well as a large magnitude of effect for PP. |
| first_indexed | 2024-04-11T23:44:20Z |
| format | Article |
| id | doaj.art-61efc5dcd7974008929572dfcf312dea |
| institution | Directory Open Access Journal |
| issn | 1678-4464 |
| language | English |
| last_indexed | 2024-04-11T23:44:20Z |
| publishDate | 2018-02-01 |
| publisher | Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz |
| record_format | Article |
| series | Cadernos de Saúde Pública |
| spelling | doaj.art-61efc5dcd7974008929572dfcf312dea2022-12-22T03:56:41ZengEscola Nacional de Saúde Pública, Fundação Oswaldo CruzCadernos de Saúde Pública1678-44642018-02-0134210.1590/0102-311x00206116S0102-311X2018000202001Advanced maternal age and its association with placenta praevia and placental abruption: a meta-analysisKatrini Guidolini MartinelliÉrica Marvila GarciaEdson Theodoro dos Santos NetoSilvana Granado Nogueira da GamaThis study aimed to investigate the existence and magnitude of the association between advanced maternal age (AMA) and occurrence of placenta praevia (PP) and placental abruption (PA) among nulliparous and multiparous women, by a systematic review and meta-analysis. We searched articles published between January 1, 2005 and December 31, 2015, in any language, in the following databases: PubMed, Scopus, Web of Science, and LILACS. Women were grouped into two age categories: up to 34 years old and 35 years or older. The Newcastle-Ottawa Scale was used to evaluate the methodological quality of the studies. A meta-analysis was conducted for the PP and PA outcomes, using a meta-regression model to find possible covariates associated with heterogeneity among the studies and Egger’s test to assess publication bias. The protocol of this systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) system (CRD42016045594). Twenty-three studies met the criteria and were included in the meta-analysis. For both outcomes, an increase in age increased the magnitude of association strength, and PP (OR = 3.16, 95%CI: 2.79-3.57) was more strongly associated with AMA than PA (OR = 1.44, 95%CI: 1.35-1.54). For parity, there was no difference between nulliparous and multiparous women considered older for the PP and PA outcomes. Our review provided very low-quality evidence for both outcomes, since it encompasses observational studies with high statistical heterogeneity, diversity of populations, no control of confounding factors in several cases, and publication bias. However, the confidence intervals were small and there is a dose-response gradient, as well as a large magnitude of effect for PP.http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0102-311X2018000202001&lng=en&tlng=enMaternal AgePlacenta PreviaAbruptio PlacentaePregnancy Complications |
| spellingShingle | Katrini Guidolini Martinelli Érica Marvila Garcia Edson Theodoro dos Santos Neto Silvana Granado Nogueira da Gama Advanced maternal age and its association with placenta praevia and placental abruption: a meta-analysis Cadernos de Saúde Pública Maternal Age Placenta Previa Abruptio Placentae Pregnancy Complications |
| title | Advanced maternal age and its association with placenta praevia and placental abruption: a meta-analysis |
| title_full | Advanced maternal age and its association with placenta praevia and placental abruption: a meta-analysis |
| title_fullStr | Advanced maternal age and its association with placenta praevia and placental abruption: a meta-analysis |
| title_full_unstemmed | Advanced maternal age and its association with placenta praevia and placental abruption: a meta-analysis |
| title_short | Advanced maternal age and its association with placenta praevia and placental abruption: a meta-analysis |
| title_sort | advanced maternal age and its association with placenta praevia and placental abruption a meta analysis |
| topic | Maternal Age Placenta Previa Abruptio Placentae Pregnancy Complications |
| url | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0102-311X2018000202001&lng=en&tlng=en |
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