The Effect of Very Advanced Maternal Age on Maternal and Neonatal Outcomes: A Systematic Review Jordana Leader, BSc, Amrit Bajwa, Andrea Lanes, MSc,

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The Effect of Very Advanced Maternal Age on Maternal and Neonatal Outcomes: A Systematic Review Jordana Leader, BSc, Amrit Bajwa, Andrea Lanes, MSc, PhD, Xiaolin Hua, MD, PhD, Ruth Rennicks White, RN, BScN, Natalie Rybak, BSc, Mark Walker, MD, FRCS(C), MSc(epi), MScHCM Journal of Obstetrics and Gynaecology Canada Volume 40, Issue 9, Pages 1208-1218 (September 2018) DOI: 10.1016/j.jogc.2017.10.027 Copyright © 2018 Society of Obstetricians and Gynaecologists of Canada Terms and Conditions

Figure 1 Flow diagram illustrating the selection of studies for the systematic review. Journal of Obstetrics and Gynaecology Canada 2018 40, 1208-1218DOI: (10.1016/j.jogc.2017.10.027) Copyright © 2018 Society of Obstetricians and Gynaecologists of Canada Terms and Conditions

Figure 2 Forest plot representing the likelihood of fetal loss in women ≥45 years of age compared with women <45 years of age. Journal of Obstetrics and Gynaecology Canada 2018 40, 1208-1218DOI: (10.1016/j.jogc.2017.10.027) Copyright © 2018 Society of Obstetricians and Gynaecologists of Canada Terms and Conditions

Figure 3 Forest plot representing the likelihood of an abnormal 5-minute APGAR score in neonates of women ≥45 years of age compared with women <45 years of age. Journal of Obstetrics and Gynaecology Canada 2018 40, 1208-1218DOI: (10.1016/j.jogc.2017.10.027) Copyright © 2018 Society of Obstetricians and Gynaecologists of Canada Terms and Conditions

Figure 4 Forest plot representing the likelihood of IUGR in women ≥45 years of age compared with women <45 years of age. Journal of Obstetrics and Gynaecology Canada 2018 40, 1208-1218DOI: (10.1016/j.jogc.2017.10.027) Copyright © 2018 Society of Obstetricians and Gynaecologists of Canada Terms and Conditions

Figure 5 Forest plot representing the likelihood of complications of pregnancy (hyperemesis, hypertension disorder in pregnancy, diabetes, placental previa, placental accrete/increta in women ≥45 years of age compared with women <45 years of age. Journal of Obstetrics and Gynaecology Canada 2018 40, 1208-1218DOI: (10.1016/j.jogc.2017.10.027) Copyright © 2018 Society of Obstetricians and Gynaecologists of Canada Terms and Conditions

Figure 6 Forest plot representing the likelihood of preterm birth in women ≥45 years of age compared with women <45 years of age. Journal of Obstetrics and Gynaecology Canada 2018 40, 1208-1218DOI: (10.1016/j.jogc.2017.10.027) Copyright © 2018 Society of Obstetricians and Gynaecologists of Canada Terms and Conditions

Figure 7 Forest plot representing the likelihood of delivering through CS in women ≥45 years of age compared with women <45 years of age. Journal of Obstetrics and Gynaecology Canada 2018 40, 1208-1218DOI: (10.1016/j.jogc.2017.10.027) Copyright © 2018 Society of Obstetricians and Gynaecologists of Canada Terms and Conditions

Figure 8 Forest plot representing the likelihood of periconception hemorrhage (transfusion, hysterectomy, rate of ICU admission) in women ≥45 years of age compared with women <45 years of age. Journal of Obstetrics and Gynaecology Canada 2018 40, 1208-1218DOI: (10.1016/j.jogc.2017.10.027) Copyright © 2018 Society of Obstetricians and Gynaecologists of Canada Terms and Conditions