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The risk and obstetric outcomes of preeclampsia in pregnancies with non-ideal maternal age: a systematic review

Azizah Universitas Jenderal Soedirman, Indonesia Correspondence azizah003@mhs.unsoed.ac.id
,
Siwi Pramatama Mars Wijayanti Universitas Jenderal Soedirman, Indonesia Correspondence siwi.wijayanti@unsoed.ac.id
,
Dwi Sarwani Sri Rejeki Universitas Jenderal Soedirman, Indonesia Correspondence dwi.rejeki@unsoed.ac.id
Pages 157-171
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Abstract

Preeclampsia remains a leading cause of maternal and neonatal morbidity, with increased risk observed at both extremes of maternal age adolescents (<20 years) and women of advanced maternal age (>35 years). However, the comparative obstetric impacts of preeclampsia across these age groups remain underexplored in a structured synthesis. This study aims to provide an up-to-date, evidence-based understanding to support maternal health policy planning, clinical obstetrics, and reproductive education tailored to high-risk populations. This systematic review was conducted following PRISMA guidelines. Electronic databases including PubMed, Scopus, and Google Scholar were searched for peer-reviewed studies published between 2015 and 2025. Studies were eligible if they reported preeclampsia prevalence and obstetric outcomes among pregnant individuals aged <20 or >35 years. Seven observational and cohort studies met the inclusion criteria. Adolescent pregnancies complicated by preeclampsia showed high cesarean section rates (82.9% in those aged ?16 and 89.3% in ages 17–19), and increased risk of anemia and pregnancy complications despite comparable neonatal outcomes across age subgroups. In contrast, advanced maternal age was associated with a higher prevalence of severe preeclampsia (68.9%), eclampsia (12.3%), HELLP syndrome (8.7%), and emergency cesarean delivery (71.3%). Neonatal complications included low birth weight (34.4%) and lower five-minute Apgar scores. Use of assisted reproductive technologies in women ?40 further amplified the risk of early-onset preeclampsia and prematurity. Pregnancies at non-ideal maternal ages carry distinct pathophysiological risks and result in increased obstetric complexity and need for medical intervention. Age-specific clinical approaches such as early screening, targeted antenatal education, and enhanced maternal-fetal surveillance are essential. These findings support maternal health policies that incorporate maternal age as a key determinant for individualized risk assessment and care planning.

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References

  • Yang S, Zhou W, Dimitriadis E, Menkhorst E. Maternal blood lipoprotein cholesterol prior to and at the time of diagnosis of preeclampsia: a systematic review. Am J Obstet Gynecol MFM. 2025 May;7(5):101654.
  • Al-Taiar A, Rahman ME, Salama M, Ziyab AH, Karmaus W. Impacts of Ramadan fasting during pregnancy on pregnancy and birth outcomes: An umbrella review. Int J Gynaecol Obstet Off Organ Int Fed Gynaecol Obstet. 2025 June;169(3):968–78.
  • Shan D, Han J, Tan X, Yu P, Cai Y, Yi K. Mortality rate and risk factors for relaparotomy after caesarean section: a systematic review and meta-analysis. BMC Pregnancy Childbirth. 2025 Mar 11;25(1):269.
  • Chen D, Gao X, Yang T, Xin X, Wang G, Wang H, et al. Independent risk factors for placental abruption: a systematic review and meta-analysis. BMC Pregnancy Childbirth. 2025 Mar 26;25(1):351.
  • Masters C, Wu C, Gleeson D, Serafica M, Thomas JL, Ickovics JR. Scoping review of climate drivers on maternal health: current evidence and clinical implications. AJOG Glob Rep. 2025 Jan 17;5(1):100444.
  • Hedermann G, Hedley PL, Gadsbøll K, Thagaard IN, Krebs L, Karlsen MA, et al. Adverse Obstetric Outcomes in Pregnancies With Major Fetal Congenital Heart Defects. JAMA Pediatr. 2025 Feb 1;179(2):163–70.
  • Brunner K, Linder T, Klaritsch P, Tura A, Windsperger K, Göbl C. The Impact of Overweight and Obesity on Pregnancy: A Narrative Review of Physiological Consequences, Risks and Challenges in Prenatal Care, and Early Intervention Strategies. Curr Diab Rep. 2025 Apr 21;25(1):30.
  • Yo JH, Fields N, Li W, Anderson A, Marshall SA, Kerr PG, et al. Adverse Pregnancy Outcomes in Solid Organ Transplant Recipients: A Systematic Review and Meta-Analysis. JAMA Netw Open. 2024 Aug 1;7(8):e2430913.
  • van Eekhout JCA, Becking EC, Scheffer PG, Koutsoliakos I, Bax CJ, Henneman L, et al. First-Trimester Prediction Models Based on Maternal Characteristics for Adverse Pregnancy Outcomes: A Systematic Review and Meta-Analysis. BJOG Int J Obstet Gynaecol. 2025 Feb;132(3):243–65.
  • Parra-Pingel PE, Quisiguiña-Avellán LA, Hidalgo L, Chedraui P, Pérez-López FR. Pregnancy outcomes in younger and older adolescent mothers with severe preeclampsia. Adolesc Health Med Ther. 2017;8:81–6.
  • Husna F, Akbar MIA, Amalia RB. Hubungan Usia Ibu dengan Kejadian Komplikasi Kehamilan. J Kedokt Diponegoro. 2019;8(1):23–30.
  • Lazzari C, Bosco M, Garzon S, Simonetto C, Casarin J, Paolucci S, et al. The impact of maternal age and body mass index on hypertensive disorders of pregnancy: Moving beyond the cut-off effect. Pregnancy Hypertens. 2025 June;40:101219.
  • Buciu VB, Novacescu D, Zara F, ?erban DM, Tomescu L, Ciurescu S, et al. Development of a Risk Score for the Prediction and Management of Pre-Eclampsia in Low-Resource Settings. J Clin Med. 2025 Jan;14(10):3398.
  • Gurza G, Martínez-Cruz N, Lizano-Jubert I, Arce-Sánchez L, Suárez-Rico BV, Estrada-Gutierrez G, et al. Association of the Triglyceride–Glucose Index During the First Trimester of Pregnancy with Adverse Perinatal Outcomes. Diagnostics. 2025 Jan;15(9):1129.
  • Li Q, Wei X, Zeng W, Lin Y. Impact of IVF-ET on obstetrics and perinatal outcomes in advanced maternal age women. Placenta. 2025 June 26;167:55–62.
  • Chonnak U, Pongsatha S, Luewan S, Sirilert S, Tongsong T. Pregnancy outcomes among women near the end of reproductive age. BMC Pregnancy Childbirth. 2025 Apr 25;25(1):493.
  • Scime NV, Chaput KH, Faris PD, Quan H, Tough SC, Metcalfe A. Pregnancy complications and risk of preterm birth according to maternal age: A population-based study of delivery hospitalizations in Alberta. Acta Obstet Gynecol Scand. 2020;99(4):459–68.
  • de la Calle M, Bartha JL, Lopez CM, Turiel M, Martinez N, Arribas SM, et al. Younger Age in Adolescent Pregnancies Is Associated with Higher Risk of Adverse Outcomes. Int J Environ Res Public Health. 2021 Jan;18(16):8514.
  • Carr RC, McKinney DN, Cherry AL, Defranco EA. Maternal age-specific drivers of severe maternal morbidity. Am J Obstet Gynecol MFM. 2022 Mar;4(2):100529.
  • Lisonkova S, Potts J, Muraca GM, Razaz N, Sabr Y, Chan WS, et al. Maternal age and severe maternal morbidity: A population-based retrospective cohort study. PLoS Med. 2017 May;14(5):e1002307.
  • Zhang T, Wang H, Wang X, Yang Y, Zhang Y, Tang Z, et al. The adverse maternal and perinatal outcomes of adolescent pregnancy: a cross sectional study in Hebei, China. BMC Pregnancy Childbirth. 2020 June 1;20(1):339.
  • Bartsch E, Medcalf KE, Park AL, Ray JG. Clinical risk factors for pre-eclampsia determined in early pregnancy: systematic review and meta-analysis of large cohort studies. 2016 Apr 19 [cited 2025 Oct 15]; Available from: https://www.bmj.com/content/353/bmj.i1753
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How to Cite This

Azizah, Wijayanti , S. P. M. ., & Rejeki, D. S. S. . (2025). The risk and obstetric outcomes of preeclampsia in pregnancies with non-ideal maternal age: a systematic review. Jurnal Kesehatan Ibu Dan Anak, 18(2), 157–171. https://doi.org/10.29238/kia.v18i2.2805

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All data generated during this study are included in this published article [and its supplementary information files].