Hypertension in pregnancy · 2026
Advanced maternal age is a risk factor for both early-onset and late-onset hypertensive disorders of pregnancy: the Japan environment and children's study.
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Tagami Kazuma, Iwama Noriyuki, Hamada Hirotaka, Tomita Hasumi, Kumagai Natsumi, Wang Hongxin, Izumi Seiya, Watanabe Zen, Ishikuro Mami, Obara Taku, Metoki Hirohito, Miura Yuichiro, Ota Chiharu, Kuriyama Shinichi, Arima Takahiro, Yaegashi Nobuo, Saito Masatoshi, Japan Environment and Children’s Study Group
Аннотация
OBJECTIVE: Advanced maternal age (AMA, ≥35 years), particularly prevalent in Japan, is associated with adverse perinatal outcomes, including hypertensive disorders of pregnancy (HDP), which vary in severity based on the timing of onset (early-onset and late-onset). This study aimed to investigate the association between maternal age and early-onset and late-onset HDP.
METHODS: A total of 80,872 pregnant women were included in this prospective birth cohort study. Associations between maternal age and early-onset, preterm late-onset, and term late-onset HDP were evaluated using a multinomial logistic regression model adjusted for potential confounding factors. Maternal age was categorized into five: <25, 25‒29.9, 30‒34.9, 35‒39.9, and ≥40 years, with the reference category set as 30‒34.9 years.
RESULTS: Higher maternal age was significantly associated with increased odds of developing early-onset, preterm late-onset, and term late-onset HDP. The adjusted odds ratios (aORs) for early-onset HDP in women aged 35‒39.9 and ≥40 years were 2.724 (95% confidence interval [CI]: 2.095-3.542) and 3.493 (95% CI: 2.349-5.196), respectively. Regarding preterm late-onset HDP, the aORs were 1.346 (95% CI: 1.057-1.714) and 3.011 (95% CI: 2.171-4.176) for these age groups, respectively. Similarly, the aORs for term late-onset HDP were 1.417 (95% CI: 1.206-1.664) and 1.762 (95% CI: 1.341-2.316), respectively.
CONCLUSION: Higher maternal age was associated with an increased HDP risk, irrespective of diagnosis timing. Associations between maternal age and early-onset and preterm late-onset HDP were stronger than that with t erm late-onset HDP.
METHODS: A total of 80,872 pregnant women were included in this prospective birth cohort study. Associations between maternal age and early-onset, preterm late-onset, and term late-onset HDP were evaluated using a multinomial logistic regression model adjusted for potential confounding factors. Maternal age was categorized into five: <25, 25‒29.9, 30‒34.9, 35‒39.9, and ≥40 years, with the reference category set as 30‒34.9 years.
RESULTS: Higher maternal age was significantly associated with increased odds of developing early-onset, preterm late-onset, and term late-onset HDP. The adjusted odds ratios (aORs) for early-onset HDP in women aged 35‒39.9 and ≥40 years were 2.724 (95% confidence interval [CI]: 2.095-3.542) and 3.493 (95% CI: 2.349-5.196), respectively. Regarding preterm late-onset HDP, the aORs were 1.346 (95% CI: 1.057-1.714) and 3.011 (95% CI: 2.171-4.176) for these age groups, respectively. Similarly, the aORs for term late-onset HDP were 1.417 (95% CI: 1.206-1.664) and 1.762 (95% CI: 1.341-2.316), respectively.
CONCLUSION: Higher maternal age was associated with an increased HDP risk, irrespective of diagnosis timing. Associations between maternal age and early-onset and preterm late-onset HDP were stronger than that with t erm late-onset HDP.