Adverse pregnancy outcomes associated with advanced maternal age among Libyan women: a cross-sectional study at Benghazi medical centre

IntroductionAdvanced maternal age (AMA), commonly defined as maternal age ≥35 years, has been associated with adverse pregnancy outcomes. However, evidence from Libya and the wider North African region remains limited. This study examined maternal and neonatal outcomes associated with AMA in a Libyan cohort.MethodsThis retrospective, record-based cross-sectional study included deliveries at Benghazi Medical Centre between 1 April 2017 and 25 December 2019. A systematic random sample of 450 singleton delivery records was selected from 9,450 eligible deliveries. After excluding six women aged 17–19 years, the final analysis included 444 women aged 20–45 years. Firth penalized-likelihood logistic regression was used to adjust for parity, body mass index, and pre-existing diabetes mellitus.ResultsOf the 444 women included, 243 (54.7%) were aged ≥35 years. AMA was associated with higher crude odds of preterm labour (OR 2.01, 95% CI 1.09–3.68) and preterm birth (OR 2.08, 95% CI 1.12–3.86). After adjustment, these associations were attenuated, and the confidence intervals included the null (aOR 1.76, 95% CI 0.93–3.31 and aOR 1.87, 95% CI 0.98–3.56, respectively). Pre-existing diabetes was observed only among women aged ≥35 years. Meconium aspiration was less frequent in the AMA group, although this finding should be interpreted cautiously because of the small number of events.DiscussionIn this predominantly multiparous Libyan cohort from a tertiary referral centre, adjustment for baseline maternal characteristics reduced the strength of the main crude associations with maternal age. These findings suggest that maternal age should be considered alongside parity and maternal medical history when assessing antenatal risk.