Although women over age 50 who become pregnant via egg donation are at an elevated risk for developing obstetrical complications, their complication rates are similar to those of younger recipients, according to a study by Columbia University Medical Center researchers to be published in the February 2012 issue of the American Journal of Perinatology. This is contrary to epidemiological data suggesting that these women are at greater risk of certain complications of pregnancy, including hypertension, gestational diabetes, premature birth, and placenta abnormalities.
In the largest single-center study of older women who became pregnant from egg donation, Mark V. Sauer, MD; Daniel H. Kort, MD; and colleagues studied 101 women age 50 and over. They compared their pregnancy results with those of egg-donation recipients age 42 and younger. The two groups were evaluated for significant differences in perinatal complications, gestational age at delivery, baby's birth weight, and mode of delivery. Although the women all received their fertility treatment at Columbia University Center for Reproductive Care, their prenatal care and delivery often took place elsewhere.
Both older and younger women had similar rates of gestational hypertension, diabetes, cesarean delivery, and premature birth. Two women in the older group experienced a serious adverse effect. A 56-year-old woman developed heavy vaginal bleeding at 29 weeks of pregnancy and had to deliver by emergency cesarean hysterectomy at 2 weeks later. She recovered with no further complications. A 49-year-old woman (who would have been age 50 at term) died following acute cardiac arrest in her first trimester. The researchers believe that her death was unrelated to her pregnancy and more likely attributable to her heavy smoking habit, which she had not disclosed to her doctors.
The study concluded that all women who use egg donation to become pregnant are at an elevated risk for obstetrical complications, particularly hypertensive disorders and cesarean section; but women over age 50 do not appear to face any greater risk than their younger counterparts.
"It is imperative that all older women undergo thorough medical screening before attempting pregnancy to ensure the best possible outcome," said Mark Sauer, professor of obstetrics and gynecology at Columbia University Medical Center (CUMC). "But, really, that should apply to younger women, as well."
"Although many social and ethical questions surround the use of assisted reproductive technology by this age group, the current study confirms the high success rate and relative safety of such pregnancies in well-cared-for women," said Daniel H. Kort, a postdoctoral fellow in obstetrics and gynecology.
The study's authors are Daniel H. Kort, MD (CUMC); Jennifer Gosselin, PhD (CUMC); Janet M. Choi, MD (CUMC); Melvin H. Thornton, MD; Jane Cleary-Goldman, MD (Mount Sinai Medical Center); and Mark V. Sauer, MD (CUMC).
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