Trends in Perinatal Outcomes Across Maternal Age Groups in Taiwan, 2004-2021
Author(s)
Hui-Min Chuang, PharmD1, Lin-Chieh Meng2, Hsi-Yu Lai2, Liang-Kung Chen2, Fei-Yuan Sharon Hsiao, PhD2.
1Research assistant, National Taiwan University, Taipei City, Taiwan, 2
1Research assistant, National Taiwan University, Taipei City, Taiwan, 2
OBJECTIVES: Maternal age has shifted significantly in recent decades, with a marked increase in the proportion of advanced maternal age, potentially influencing perinatal health outcomes. This study aimed to examine trends in maternal and neonatal adverse outcomes across maternal age groups in Taiwan.
METHODS: This nationwide cohort study utilized data from the National Health Insurance (NHI) Database and Birth Certificate Application (BCA) records from 2004 to 2021. Maternal outcomes included 30-day mortality, gestational diabetes, and hypertensive disorders (gestational hypertension, mild/severe pre-eclampsia). Neonatal outcomes included stillbirth, preterm birth, low birth weight (LBW), small for gestational age (SGA), and large for gestational age (LGA).
RESULTS: A total of 3,415,088 singleton births were included, and the proportion of pregnancies with advanced maternal age increased from 12% to 35% between 2004 and 2021. Maternal mortality remained very low during the study period (0.01%-0.02%), while other maternal adverse outcomes increased and were more prevalent among advanced maternal age pregnancies. Gestational diabetes rose from 2.0% in 2004 to 9.3% in 2021 (2021: 7.4% in pregnancies aged <35 years vs. 13.2% in those aged ≥35 years); gestational hypertension increased from 0.4% to 2.1% (2021: 1.7% vs. 2.9%); mild pre-eclampsia from 0.8% to 3.1% (2021: 2.5% vs. 4.1%); and severe pre-eclampsia from 0.5% to 2.9% (2021: 2.4% vs. 3.8%). Neonatal outcomes showed similar trends, with preterm birth increasing from 7.9% to 8.7% and low birth weight from 6.3% to 8.8%, while stillbirth remained relatively stable. Most neonatal outcomes were more frequent among advanced maternal age pregnancies (2021: stillbirth, 0.9% vs. 1.4%; preterm birth, 7.9% vs. 10.3%; LBW, 8.3% vs. 9.8%, LGA, 8.9% vs. 11.4%), except for SGA (10.2% vs. 9.0%).
CONCLUSIONS: This nationwide analysis highlights increasing maternal and neonatal risks, with consistently higher rates in advanced maternal age pregnancies. The rising maternal age trend warrants continued surveillance.
METHODS: This nationwide cohort study utilized data from the National Health Insurance (NHI) Database and Birth Certificate Application (BCA) records from 2004 to 2021. Maternal outcomes included 30-day mortality, gestational diabetes, and hypertensive disorders (gestational hypertension, mild/severe pre-eclampsia). Neonatal outcomes included stillbirth, preterm birth, low birth weight (LBW), small for gestational age (SGA), and large for gestational age (LGA).
RESULTS: A total of 3,415,088 singleton births were included, and the proportion of pregnancies with advanced maternal age increased from 12% to 35% between 2004 and 2021. Maternal mortality remained very low during the study period (0.01%-0.02%), while other maternal adverse outcomes increased and were more prevalent among advanced maternal age pregnancies. Gestational diabetes rose from 2.0% in 2004 to 9.3% in 2021 (2021: 7.4% in pregnancies aged <35 years vs. 13.2% in those aged ≥35 years); gestational hypertension increased from 0.4% to 2.1% (2021: 1.7% vs. 2.9%); mild pre-eclampsia from 0.8% to 3.1% (2021: 2.5% vs. 4.1%); and severe pre-eclampsia from 0.5% to 2.9% (2021: 2.4% vs. 3.8%). Neonatal outcomes showed similar trends, with preterm birth increasing from 7.9% to 8.7% and low birth weight from 6.3% to 8.8%, while stillbirth remained relatively stable. Most neonatal outcomes were more frequent among advanced maternal age pregnancies (2021: stillbirth, 0.9% vs. 1.4%; preterm birth, 7.9% vs. 10.3%; LBW, 8.3% vs. 9.8%, LGA, 8.9% vs. 11.4%), except for SGA (10.2% vs. 9.0%).
CONCLUSIONS: This nationwide analysis highlights increasing maternal and neonatal risks, with consistently higher rates in advanced maternal age pregnancies. The rising maternal age trend warrants continued surveillance.
Conference/Value in Health Info
2025-09, ISPOR Real-World Evidence Summit 2025, Tokyo, Japan
Value in Health Regional, Volume 49S (September 2025)
Code
RWD241
Topic Subcategory
Health & Insurance Records Systems
Disease
SDC: Reproductive & Sexual Health