This research involved the study of fifteen women who had their first child after the age of 30. By the use of an hour and half long unstructured interview it was discovered how these women experienced delayed motherhood, what problems they had and their coping strategies. From the transcripts of the interviews, the material was analyzed into 16 topics. From these 16 topics, 8 specific recommendations were developed to help women who delay having children in the transition to parenthood. The research concluded that although there are problems for women who delay having children, most women are content with their decision. They have developed strategies to cope with the problems they face. / Education, Faculty of / Educational and Counselling Psychology, and Special Education (ECPS), Department of / Graduate

Background: This study examined the relationship between mothers’ age at first birth and infant mortality in Zimbabwe. Childbearing at a significantly young age has been noted to be a predictor of infant mortality, as children born to young mothers are at a greater risk of early death. Methods: This is a cross-sectional, secondary study which uses the data from the Zimbabwe Demographic and Health Survey 2005-2006. The population of interest in this study are women of reproductive ages in Zimbabwe, who have had children within the last five years prior to the survey. A total of 4074 women are used as the sample in this study. The dependent variable is infant mortality, which is understood as the deaths of infants between the period of birth and their first birthday. The independent variables include demographic, socio-economic and reproductive characteristics of the women. The analysis of data was undertaken at three levels. Univariate analysis, binary logistic regression and multivariate logistic regression were conducted. In addition, stepwise logistic regression was applied to the multivariate analysis to analyse the relationship between the significant variables found in the study in relation to infant mortality. Results: This study confirmed an association between mothers’ age at first birth and infant mortality as infants born to mothers of 18 years and younger suffer higher risk of infant mortality, as they have a 33% increased risk in comparison to infants born to older women. This indicates the need for policy development focused on the issue adolescent childbearing and how childbearing can be delayed in Zimbabwe in order to reduce infant mortality. Furthermore the reproductive characteristics of the mother prove to have great impact on infant mortality within the country. Thus the importance of policies focused on women’s reproductive health care. Conclusions: This study confirms that mothers’ age at first birth is a central influential factor in infant mortality in Zimbabwe. Infant mortality cannot be isolated from the characteristics of mothers, in particular her age at first birth, as they are more often the primary care-givers thus have immense influence on whether the infants survive or not.

Genetic counseling for women with advanced maternal age is well established medical standard of care. However, only one study has yet been done to test the validity of that policy. Records of 283 patients referred for genetic counseling with advanced maternal age as a primary indication were examined. Of these, 57.6% had at least one additional indication. This value did differ significantly from Rubin's data which reported a 43.3% rate (X2 = 13.01, p > 0.001). The additional indications were broken down according to McKusick's system, and a statistical difference between my and Rubin's data was found in the autosomal dominant, autosomal recessive, potential teratogenic exposure and miscellaneous categories. There was no significant statistical difference between my and Rubin's data in the X-linked, chromosomal anomalies and multifactorial groups. These data underscore the need for physicians to refer patients with advanced maternal age for genetic counseling, and provides a scientific basis for doing so.

No description available.

This qualitative study used a phenomenological approach to understand the experience of 10 later-life mothers who had a first child at age 35 or older and were in the process of raising a teenager. Data were collected with semi-structured interviews and analyzed using thematic coding. Initial findings suggest maternal age contributes to a positive parenting outcome due to life experience, emotional maturity and financial security. Drawbacks include fatigue and reduced fertility that limited family size, as well as competing life stages such as retirement and college. Older mothers felt in the mainstream. Clinical implications are discussed. / Master of Science

Thesis (Ph. D.)--University of Alabama at Birmingham, 2007. / Title from first page of PDF file (viewed Feb. 7, 2008). Includes bibliographical references.

Thesis (Ph. D.)--University of Notre Dame, 2006. / Thesis directed by John Borkowski for the Department of Psychology. "July 2006." Includes bibliographical references (leaves 63-74).

Advanced maternal age (AMA) is defined as childbearing in mothers ≥35 years of age and is becoming increasingly prevalent in high income countries. AMA has been associated with increased risk of adverse pregnancy outcomes, particularly stillbirth. Although AMA mothers have higher rates of chromosomal abnormalities and maternal co-morbidities, AMA remains an independent risk factor for stillbirth. Despite these findings, the etiology behind this increased risk is unknown. We hypothesise that an altered maternal environment, including increased oxidative stress and inflammation, due to ageing causes placental dysfunction which increases AMA mothers’ vulnerability to stillbirth. A holistic approach was applied to investigate placental dysfunction in AMA. Firstly, a systematic review and meta-analysis comprehensively reviewed existing data on AMA and associated adverse pregnancy outcomes. Secondly, Manchester Advanced Maternal Age Study (MAMAS), a multi-centre prospective observational cohort study, was conducted to investigate risk factors for composite adverse pregnancy outcome (CAPO) in AMA. MAMAS utilised both uni- and multivariate analysis on demographic and clinical data, and measuring biomarkers of ageing and placental dysfunction by ELISA in maternal circulation during the third trimester of pregnancy. Utero-placental dysfunction was directly investigated in uncomplicated AMA pregnancies by quantifying placental morphology, placental nutrient transport capabilities and both placental and maternal uterine vascular responses. Finally, a C57BL/6J murine model of AMA was developed and characterised to further investigate maternal age on pregnancy outcome and the role of the placenta. In the meta-analysis, maternal age was linearly associated with increased risk of stillbirth and other adverse outcomes strongly associated with placental dysfunction (fetal growth restriction, preeclampsia and placental abruption). In MAMAS, smoking status and primiparity were predictive of CAPO. After adjustment, AMA mothers had an odd ratio of 2.05-3.43 of CAPO compared to 20-30 year old mothers. AMA mothers showed evidence of increased oxidative stress and pro-inflammatory bias. AMA mothers who suffered CAPO showed reduced placental endocrine capacity seen in placental dysfunction. Placentas from uneventful AMA pregnancies showed evidence of accelerated ageing and placental adaptation with increased nutrient transport, increased placental weight but reduced efficiency, and altered vascular function. AMA mice showed many similar aspects to human AMA with increased fetal loss, fetal growth restriction and increased placental size. These studies provide robust evidence for increased incidence of adverse pregnancy outcome due to placental dysfunction in pregnancies of women of AMA. This finding requires the appropriate recognition in a clinical context, with a greater focus on personalised obstetric care in an attempt to reduce stillbirth rates in this high risk population. By optimising antenatal and obstetric care for AMA mothers, we could reduce stillbirth rates by 4.7% - the population attributable risk due to AMA. These studies highlight key areas of future research that will further understanding into stillbirth risk in AMA pregnancy, test predictive models and test therapies and clinical care interventions an ultimately improve pregnancy outcome in mothers of AMA.

Magister Philosophiae - MPhil / While several interventions have been implemented over the past decade to combat child mortality, under-five mortality remains a challenge especially in Sub-Saharan Africa. Global-ly, child mortality has decreased to half from 12.7 million in 1990 to 5.9 million per year in 2015. Despite these remarkable gains, more than 16,000 children are dying daily in the world (World Health Organisation, 2015). Previous studies on child survival have examined the contributing factors of child deaths and HIV/AIDS epidemic and socio-economic differentials such as the level of education, type of place of residence,and mother’s occupational status were identified as the contributing factor towards the high rate of under-five mortality. How-ever, there is a paucity of studies focusing on the impact of socio-economic and demographic factors on under-five mortality. Hence this study aims to explore the impact of socio-economic and demographic factors on under-five mortality in South Africa. There are underlying factors or background determinants (including direct and indirect) of under-five mortality. These factors influence under-five mortality in South Africa, and the direct causes are called proximate determinants or demographic factors. The conceptual framework of Mosley and Chen (1984) was adopted to explore the ways of influence of the underlying factors on under-five mortality in their study of determinants of child survival.

Poor egg quality is the leading cause of pregnancy loss and Down's syndrome. While even eggs in young women frequently contain an incorrect number of chromosomes and are therefore unlikely to give rise to a viable pregnancy, the incidence of chromosomally abnormal eggs increases strikingly with advancing maternal age. Why egg quality declines dramatically as women approach their forties remains one of the outstanding questions in developmental biology. This PhD thesis demonstrates how unforeseen features of kinetochore organization that are unique to meiosis render this cell division process in mammals particularly prone to errors. Firstly, my results uncovered an unexpected multi-subunit organization of the meiotic kinetochore, which is widely conserved across mammals and biases eggs towards errors. Secondly, I identified two independent mechanisms that predispose eggs from older women to aneuploidy. The first mechanism affects the fidelity of meiosis I. My analysis revealed that human oocytes challenge the paradigm that sister kinetochores are fully fused. Instead, I demonstrated that sister kinetochores disjoin as women get older, which promoted erroneous kinetochore-microtubule attachments. This in turn allowed chromosomes to rotate on the spindle and provided a mechanistic explanation for reverse segregation - a recently discovered meiotic error that is unique to humans. Secondly, I pioneered the use of super-resolution microscopy to study chromosome architecture in human eggs and discovered that individual kinetochores during meiosis II in mammals are composed of previously unidentified subdomains. In young females, these subdomains are joined together by cohesin complexes. With age, kinetochores fragment into two pieces. Fragmented kinetochores frequently attach merotelically to spindle microtubules, which predisposes aged eggs to errors. What severely hinders our progress in identifying causes of human infertility is that numerous features of human meiosis are not represented in mice. To overcome this challenge, I developed an experimental platform to mimic the age-related changes that occur in humans in oocytes from young mice. I achieved this by extending the applications of Trim-Away, a novel method to degrade endogenous proteins even in primary cells, to partially deplete proteins. Furthermore, I established a new experimental model system to study human-like aspects of meiosis in live non-rodent cells in real time: pig oocytes. Together, these results set foundations for new therapeutic approaches to extend reproductive lifespan by counteracting the age-related loss in kinetochore integrity that this study identified. Furthermore, partial Trim-Away and studying meiosis in pigs opens new directions for meiotic research.