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Over the past several decades, economic, technologicand social changes in the developed world have sig-nificantly increased the number of women who delay childbirth to their late 30s and beyond. Between 1980 and 1993 in the European Union, the mean maternal age at first birth rose by 1.5 years, from 27.1 to 28.6 years.1 Between 1991 and 2001 in the United States, the percentage of first births for women 35–39 years of age increased by 36 % and that for women 40–44 years of age increased by 70%.2,3 This huge de-mographic shift has become an important public health issue, since numerous studies have indicated that increased mater-nal age (35 years of age or older) is associated with an in-creased risk of maternal morbidity, obstetric interventions and adverse pregnancy outcomes.4–11 The intention to conceive and the timing of conception are complex issues influenced by many factors. Understanding the potential outcomes of pregnancy at an advanced maternal age may constitute one of these factors. Stillbirth, or late fetal death, is one of the adverse pregnancy outcomes of most con-cern, but studies on the relation between increased maternal age and stillbirth risk have led to inconsistent conclusions. We therefore conducted a systematic review of observational studies to explore the association between advanced maternal age and the risk of stillbirth. Method