EARLY SINGLETON PREGNANCY OUTCOME - EFFECTS OF MATERNAL AGE AND MODE OF CONCEPTION

PURPOSE: To assess the effect of prognostic factors on the outcome of singleton pregnancies. MATERIALS AND METHODS: First-trimester ultrason ographic (US) scans that demonstrated a living fetus in 4,156 consecut ive singleton pregnancies were studied. The relationship between outco me and maternal age, mode of conception, maternal symptoms, and US fin dings was evaluated. RESULTS: Spontaneous abortion occurred in 371 of 4,156 (8.9%) cases. Higher pregnancy-loss rates were associated with o lder maternal age (P < 10(-5)), assisted mode of conception (P < 10(-8 )), maternal symptoms of pain and/or bleeding (P < .001), and abnormal US findings (P < 10(-8)). US abnormalities were more frequent in olde r women than in younger women (P < 10(-5)) and in assisted conceptions than in natural conceptions (P < 10(-8)). At stepwise logistic regres sion, with gestational age as a covariate, US abnormalities and matern al symptoms independently affected pregnancy outcome. Maternal age and mode of conception had no further statistically significant effect on pregnancy outcome. CONCLUSION The prognosis for older mothers and for those with assisted conception is not statistically significantly dif ferent from that for younger mothers and for those with natural concep tion if maternal symptoms, US findings, and gestational age are the sa me.