Main Article Content

Abstract

Purpose: This study aims to explore the relationship between advanced maternal age (≥35 years) and the risk of pregnancy complications through a qualitative perspective, emphasizing women's perceptions, experiences, and coping strategies.


Research Method: A systematic literature review methodology was employed to synthesize qualitative research findings related to advanced maternal age and pregnancy complications. Relevant studies were reviewed to identify recurring themes, contradictions, and contextual gaps.


Results and Discussion: The findings reveal that advanced maternal age is associated with heightened risks of complications such as preeclampsia, gestational diabetes, hypertension, preterm birth, and postpartum hemorrhage. Personal experiences, cultural beliefs, and access to healthcare influence perceptions of these risks. Women with higher perceived susceptibility are more likely to seek medical intervention, while those facing socio-economic barriers or cultural stigma exhibit lower health-seeking behaviors.


Implications: The study underscores the importance of developing culturally sensitive maternal health programs tailored to the needs of older pregnant women. Healthcare providers should adopt empathetic communication strategies and accessible education programs. Future research should address this study's limitations by employing mixed-methods approaches and considering broader social determinants of health.

Keywords

advanced maternal age pregnancy complications health belief model maternal health risks

Article Details

How to Cite
Nanda, K. R. (2025). Maternal Age and Risk of Pregnancy Complications: A Qualitative Study. Advances in Healthcare Research, 3(2), 132–147. https://doi.org/10.60079/ahr.v3i2.488

References

  1. Aguilar-Cordero, M. J., Lasserrot-Cuadrado, A., Mur-Villar, N., León-Ríos, X. A., Rivero-Blanco, T., & Pérez-Castillo, I. M. (2020). Vitamin D, preeclampsia and prematurity: A systematic review and meta-analysis of observational and interventional studies. Midwifery, 87, 102707. https://doi.org/https://doi.org/10.1016/j.midw.2020.102707
  2. Ahadzadeh, A. S., Sharif, S. P., Ong, F. S., & Khong, K. W. (2015). Integrating health belief model and technology acceptance model: investigating health-related internet use. Journal of Medical Internet Research, 17(2), e3564. https://doi.org/10.2196/jmir.3564
  3. Ahmad, M., Sechi, C., & Vismara, L. (2024). Advanced maternal age: a scoping review about the psychological impact on mothers, infants, and their relationship. Behavioral Sciences, 14(3), 147. https://doi.org/10.3390/bs14030147
  4. Anusuya, R., Uma, T., & Arun, M. (2024). Association between advanced maternal age and adverse pregnancy outcome. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 13(1), 119–125. https://doi.org/10.18203/2320-1770.ijrcog20234089
  5. Bessett, D. (2019). Complicating the Generational Disconnect: Pregnant Women, Grandmothers-to-be, and Medicalization. In Reproduction, Health, and Medicine (Vol. 20, pp. 129–151). Emerald Publishing Limited. https://doi.org/10.1108/S1057-629020190000020013
  6. Bosschieter, T. M., Xu, Z., Lan, H., Lengerich, B. J., Nori, H., Painter, I., Souter, V., & Caruana, R. (2024). Interpretable Predictive Models to Understand Risk Factors for Maternal and Fetal Outcomes. Journal of Healthcare Informatics Research, 8(1), 65–87. https://doi.org/10.1007/s41666-023-00151-4
  7. BPS (Badan Pusat Statistik). (2022). Tren kelahiran melalui operasi sesar di Indonesia tahun 2021. Jakarta: BPS Indonesia. Retrieved from https://www.bps.go.id
  8. Carico, R. “Ron,” Sheppard, J., & Thomas, C. B. (2021). Community pharmacists and communication in the time of COVID-19: Applying the health belief model. Research in Social and Administrative Pharmacy, 17(1), 1984–1987. https://doi.org/https://doi.org/10.1016/j.sapharm.2020.03.017
  9. Chien, S.-Y., Chuang, M.-C., & Chen, I.-P. (2020). Why people do not attend health screenings: factors that influence willingness to participate in health screenings for chronic diseases. International Journal of Environmental Research and Public Health, 17(10), 3495. https://doi.org/10.3390/ijerph17103495
  10. Cleary-Goldman, J., Malone, F. D., Vidaver, J., Ball, R. H., Nyberg, D. A., Comstock, C. H., Saade, G. R., Eddleman, K. A., Klugman, S., & Dugoff, L. (2005). Impact of maternal age on obstetric outcome. Obstetrics & Gynecology, 105(5 Part 1), 983–990. https://doi.org/10.1097/01.AOG.0000158118.75532.51
  11. Correa-de-Araujo, R., & Yoon, S. S. (Sarah). (2020). Clinical Outcomes in High-Risk Pregnancies Due to Advanced Maternal Age. Journal of Women’s Health, 30(2), 160–167. https://doi.org/10.1089/jwh.2020.8860
  12. Goisis, A., Schneider, D. C., & Myrskylä, M. (2017). The reversing association between advanced maternal age and child cognitive ability: evidence from three UK birth cohorts. International Journal of Epidemiology, 46(3), 850–859. https://doi.org/10.1093/ije/dyw354
  13. Harrison, R., Walton, M., Manias, E., Smith–Merry, J., Kelly, P., Iedema, R., & Robinson, L. (2015). The missing evidence: a systematic review of patients’ experiences of adverse events in health care. International Journal for Quality in Health Care, 27(6), 424–442. https://doi.org/10.1093/intqhc/mzv075
  14. Hochler, H., Lipschuetz, M., Suissa-Cohen, Y., Weiss, A., Sela, H. Y., Yagel, S., Rosenbloom, J. I., Grisaru-Granovsky, S., & Rottenstreich, M. (2023). The impact of advanced maternal age on pregnancy outcomes: a retrospective multicenter study. Journal of Clinical Medicine, 12(17), 5696. https://doi.org/10.3390/jcm12175696
  15. Indonesian Ministry of Health. (2022). Laporan Profil Kesehatan Indonesia 2022. Jakarta: Kementerian Kesehatan Republik Indonesia. Retrieved from https://www.kemkes.go.id
  16. Jones, C. L., Jakob D., J., Courtney L., S., Natasha R., B., Katheryn, C., & and Weaver, J. (2015). The Health Belief Model as an Explanatory Framework in Communication Research: Exploring Parallel, Serial, and Moderated Mediation. Health Communication, 30(6), 566–576. https://doi.org/10.1080/10410236.2013.873363
  17. Kenny, L. C., Lavender, T., McNamee, R., O’Neill, S. M., Mills, T., & Khashan, A. S. (2013). Advanced maternal age and adverse pregnancy outcome: evidence from a large contemporary cohort. PloS One, 8(2), e56583. https://doi.org/10.1371/journal.pone.0056583
  18. Laopaiboon, M., Lumbiganon, P., Intarut, N., Mori, R., Ganchimeg, T., Vogel, J. P., Souza, J. P., Gülmezoglu, A. M., & Network, W. H. O. M. S. on M. N. H. R. (2014). Advanced maternal age and pregnancy outcomes: a multicountry assessment. BJOG: An International Journal of Obstetrics & Gynaecology, 121, 49–56. https://doi.org/10.1111/1471-0528.12659
  19. Le, Q.-A., Akhter, R., Coulton, K. M., Vo, N. T. N., Duong, L. T. Y., Nong, H. V., Yaacoub, A., Condous, G., Eberhard, J., & Nanan, R. (2022). Periodontitis and Preeclampsia in Pregnancy: A Systematic Review and Meta-Analysis. Maternal and Child Health Journal, 26(12), 2419–2443. https://doi.org/10.1007/s10995-022-03556-6
  20. Lean, S. C., Derricott, H., Jones, R. L., & Heazell, A. E. P. (2017). Advanced maternal age and adverse pregnancy outcomes: A systematic review and meta-analysis. PloS One, 12(10), e0186287. https://doi.org/10.1371/journal.pone.0186287
  21. Li, J., Li, Y., Duan, Y., Xiao, X., Luo, J., & Luo, M. (2023). Dose-response associations of maternal age with pregnancy complications and multimorbidity among nulliparas and multiparas: A multicentric retrospective cohort study in southern China. Journal of Global Health, 13, 4117. https://doi.org/10.7189/jogh.13.04117
  22. Lin, J., Fu, Y., Han, Q., Yan, J., Chen, R., & Zhang, H. (2019). Gestational weight management and pregnancy outcomes among women of advanced maternal age. Experimental and Therapeutic Medicine, 18(3), 1723–1728. https://doi.org/10.3892/etm.2019.7752
  23. McCauley, H., Lowe, K., Furtado, N., Mangiaterra, V., & van den Broek, N. (2022). What are the essential components of antenatal care? A systematic review of the literature and development of signal functions to guide monitoring and evaluation. BJOG: An International Journal of Obstetrics & Gynaecology, 129(6), 855–867. https://doi.org/10.1111/1471-0528.17029
  24. McClure, E. M., Garces, A. L., Hibberd, P. L., Moore, J. L., Goudar, S. S., Saleem, S., Esamai, F., Patel, A., Chomba, E., Lokangaka, A., Tshefu, A., Haque, R., Bose, C. L., Liechty, E. A., Krebs, N. F., Derman, R. J., Carlo, W. A., Petri, W., Koso-Thomas, M., & Goldenberg, R. L. (2020). The Global Network Maternal Newborn Health Registry: a multi-country, community-based registry of pregnancy outcomes. Reproductive Health, 17(2), 184. https://doi.org/10.1186/s12978-020-01020-8
  25. Nelson, S. M., Telfer, E. E., & Anderson, R. A. (2013). The ageing ovary and uterus: new biological insights. Human Reproduction Update, 19(1), 67–83. https://doi.org/10.1093/humupd/dms043
  26. Office for National Statistics (ONS). (2022). Birth characteristics in England and Wales: 2021. Retrieved from https://www.ons.gov.uk
  27. Orji, R., Vassileva, J., & Mandryk, R. (2012). Towards an effective health interventions design: an extension of the health belief model. Online Journal of Public Health Informatics, 4(3), e61050. https://doi.org/10.5210/ojphi.v4i3.4321
  28. Pinheiro, R. L., Areia, A. L., Mota Pinto, A., & Donato, H. (2019). Advanced maternal age: adverse outcomes of pregnancy, a meta-analysis. Acta Medica Portuguesa, 32(3), 219–226. https://doi.org/10.20344/amp.11057
  29. Sauer, M. V. (2015). Reproduction at an advanced maternal age and maternal health. Fertility and Sterility, 103(5), 1136–1143. https://doi.org/https://doi.org/10.1016/j.fertnstert.2015.03.004
  30. Shan, D., Qiu, P.-Y., Wu, Y.-X., Chen, Q., Li, A.-L., Ramadoss, S., Wang, R.-R., & Hu, Y.-Y. (2018). Pregnancy outcomes in women of advanced maternal age: a retrospective cohort study from China. Scientific Reports, 8(1), 1–9. https://doi.org/10.33545/gynae.2024.v8.i2a.1430
  31. Shmueli, L. (2021). Predicting intention to receive COVID-19 vaccine among the general population using the health belief model and the theory of planned behavior model. BMC Public Health, 21(1), 804. https://doi.org/10.1186/s12889-021-10816-7
  32. Sidik, F. N., & Suharyo, D. M. (2024). A Comprehensive Literature Review of Maternal And Perinatal Complications According To Maternal Age. The International Journal of Medical Science and Health Research, 7(3), 61–76. https://doi.org/10.70070/p68zv021
  33. Sparić, R., Stojković, M., Plešinac, J., Pecorella, G., Malvasi, A., & Tinelli, A. (2024). Advanced maternal age (AMA) and pregnancy: a feasible but problematic event. Archives of Gynecology and Obstetrics, 310(3), 1365–1376. https://doi.org/10.1007/s00404-024-07678-w
  34. Statistics Indonesia (Badan Pusat Statistik) & ICF. (2018). Indonesia Demographic and Health Survey 2017. Jakarta, Indonesia: BPS, BKKBN, Kemenkes, and ICF. Retrieved from https://dhsprogram.com/publications/publication-fr342-dhs-final-reports.cfm
  35. Sun, S., Pellowski, J., Pisani, C., Pandey, D., Go, M., Chu, M., Ruan, J., & Werner, E. F. (2023). Experiences of stigma, psychological distress, and facilitative coping among pregnant people with gestational diabetes mellitus. BMC Pregnancy and Childbirth, 23(1), 643. https://doi.org/10.1186/s12884-023-05949-z
  36. Tao, L., Ruitong, W., Na, H., Jihong, L., Chuanxiang, Y., Lixia, D., Chunhua, H., Fenglan, S., Min, L., & and Liu, J. (2021). Acceptance of a COVID-19 vaccine and associated factors among pregnant women in China: a multi-center cross-sectional study based on health belief model. Human Vaccines & Immunotherapeutics, 17(8), 2378–2388. https://doi.org/10.1080/21645515.2021.1892432
  37. Tong, K. K., Chen, J. H., Yu, E. W., & Wu, A. M. S. (2020). Adherence to COVID‐19 precautionary measures: Applying the health belief model and generalised social beliefs to a probability community sample. Applied Psychology: Health and Well‐Being, 12(4), 1205–1223. https://doi.org/10.1111/aphw.12230
  38. Wong, M. C. S., Wong, E. L. Y., Huang, J., Cheung, A. W. L., Law, K., Chong, M. K. C., Ng, R. W. Y., Lai, C. K. C., Boon, S. S., Lau, J. T. F., Chen, Z., & Chan, P. K. S. (2021). Acceptance of the COVID-19 vaccine based on the health belief model: A population-based survey in Hong Kong. Vaccine, 39(7), 1148–1156. https://doi.org/https://doi.org/10.1016/j.vaccine.2020.12.083
  39. Yuan, Y., Zhao, Y.-J., Zhang, Q.-E., Zhang, L., Cheung, T., Jackson, T., Jiang, G.-Q., & Xiang, Y.-T. (2021). COVID-19-related stigma and its sociodemographic correlates: a comparative study. Globalization and Health, 17(1), 54. https://doi.org/10.1186/s12992-021-00705-4
  40. Zhou, Y., Yin, S., Sheng, Q., Yang, J., Liu, J., Li, H., Yuan, P., & Zhao, Y. (2023). Association of maternal age with adverse pregnancy outcomes: a prospective multicenter cohort study in China. Journal of Global Health, 13, 4161. https://doi.org/10.7189/jogh.13.04161