Background: Advanced maternal age (AMA) has been associated with various adverse obstetric, perinatal, and neonatal outcomes. This study primarily aimed to compare pregnancy outcomes in women aged 40 years and older with those aged 35–39 years, with a secondary aim to determine advanced maternal age by comparing these two age groups with those aged 20–34 years. Methods: This was a retrospective review of adults who gave birth between January 2020 and August 2024. All pregnant women in this study were single pregnancies and aged 20 years and older. Pregnant women using assisted reproductive technology and those with missing data were excluded from the study. This study included three groups of pregnant women: 20–34, 35–39, and 40 years and older. Perinatal outcomes of the three groups were compared. Results: AMA has previously been associated with various adverse obstetric outcomes. However, while there was a significant difference in birth weeks between the 20–34 years age group and the ≥40 age group (p = 0.019), the birth weeks of other age groups were similar. Moreover, there was no statistically significant difference between birth weights. Maternal ages of 35–39 and ≥40 years were associated with increased rates of cesarean delivery, pre-eclampsia, low birth weight, gestational diabetes mellitus (GDM), fetal growth restriction (FGR), preterm delivery, and low Apgar score (p < 0.001); however, rates of placental abruption, and preterm premature rupture of membranes (PPROMs) were similar to women aged <35 years. Gestational hypertension (GHT) (adjusted odds ratio (adjOR): 6.710, 95% confidence interval (95% CI): 2.755–16.343, p = < 0.001), oligohydramnios (adjOR: 2.145, 95% CI: 1.056–4.356, p = 0.035), macrosomia (adjOR: 5.459, 95% CI: 1.164–25.609, p = 0.031), and postpartum hemorrhage (adjOR: 5.139, 95% CI: 1.021–25.872, p = 0.047) are more common in women aged ≥40 years compared to both the reference group and the <35 age group. Conclusions: Adverse perinatal outcomes are more common in pregnant women aged 35 and over. These adverse outcomes are more common in the ≥40 years age group. To prevent these negative outcomes as well as potential maternal and fetal mortality and morbidity, we believe it is crucial to monitor these pregnant women closely during the prenatal period.

Aims: Despite routine prenatal care, intrauterine fetal death (IUFD) is unpredictable. With early diagnosis and prompt treatment of maternal and obstetric problems, IUFD may become less common. The aim of this study was to determine the prevalence of IUFD in pregnant patients in a tertiary care center. Methods: A descriptive cross-sectional study was conducted at a tertiary center from January 2020 to August 2024 and was approved by the Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research Hospital Scientific Research Ethics Committee (Date: 08.11.2024, Decision No: 2024/318). Demographic characteristics of pregnant women, medical and obstetric complication rates, and histopathological findings of the placenta were recorded. Results: IUFD was diagnosed in 137 of 20,356 deliveries (0.67%). Of these, 104 cases were included in the study. The period with the highest stillbirth rate was 28-33 weeks (36.3%), 46.2% of pregnant women gave birth for the first time and 77.9% were between the ages of 20-24. The most common maternal problems were maternal anemia (n=39, 37.5%). The most common perinatal outcomes were preeclampsia/eclampsia (n=12, 11.5%) and the rate of pregnant women without any perinatal problems was 57.7% (n=60). The caesarean section rate was 37.5% (n=39). In addition, the most common placental histopathological examinations were placental infarction (n=26, 25%). Conclusion: A significant amount of IUFD can be prevented with routine prenatal care of patients and society, close monitoring of risk groups, and educating pregnant women.

Amaç: Anne ölümü, sağlık sistemlerinin gelişmişliğinin önemli bir göstergesidir. Maternal near-miss, sağlık hizmeti kalitesini belirlemede maternal mortaliteden daha etkilidir. Bu çalışmanın amacı, kliniğimize başvuran gebeler arasında anne ölümünü veya ölümden dönme vakalarını belirlemek ve bu durumlara yol açan sebepleri tespit etmektir. Gereç ve Yöntemler: Retrospektif ve gözlemsel tipte olan bu araştırmada, Şehit Prof. Dr. İlhan Varank Sancaktepe Eğitim ve Araştırma Hastanesi’nde 1 Şubat 2018 - 1 Eylül 2023 tarihleri arasında antenatal takip, doğum veya doğum sonrası 42 gün içinde başvuran 95 hastanın dosyaları incelenmiştir. DSÖ tarafından tanımlanan near-miss kriterlerine uyan hastalar çalışmaya dahil edilmiştir. Bulgular: En sık görülen tanının %50,5 ile COVID-19 olduğu belirlenmiş olup, bunu sırasıyla eklampsi ve uterin kanama (%9,5), preeklampsi (%7,4) ve plasenta previa (%6,3) takip etmektedir. Katılımcıların %27,6’sı yaşamını sürdürmüş, %72,4’ü yaşamını yitirmiştir. COVID-19 tanısı alan hastalarda Maternal Severity Skoru, İndeksi, hastanede ve yoğun bakımda kalış süreleri, COVID-19 olmayanlara göre anlamlı şekilde daha yüksek bulunmuştur. Eklampsi vakalarında hastanede ve yoğun bakımda kalış süreleri ile maternal mortalite oranları, diğer vakalara kıyasla anlamlı olarak yüksek seyretmiştir. Kardiyovasküler ve respiratuar disfonksiyonun varlığı, maternal ölüm riskini güçlü biçimde arttırmıştır. Sonuç: Anne ölümlerini önlemede erken tanı ve müdahale önemlidir. Hızlı ve doğru tanı ile gerekli müdahalelerin ivedilikle yapılması, anne kayıplarını önleyebilir. Daha fazla araştırma yapılması gerektiği sonucuna varılmıştır.