A study of fetomaternal outcome in elderly primigravida
Keywords:Elderly primigravida, High risk pregnancy, Maternal and fetal complications
Background: Elderly primigravida is defined as all women going through their first pregnancy over the age of ≥35 years. They are considered to be categorized as high-risk pregnancy. Advanced contraception methods and artificial reproductive technology have played key role in delaying the pregnancy.
Methods: A retrospective study of fetomaternal outcome in elderly primigravida was conducted at department of obstetrics and gynecology, GMERS medical college, Junagadh from 1st September 2021 to 1st August 2022. All the patient data was obtained from their case records and indoor files and were followed up till delivery for fetal outcome.
Results: There were 54 elderly primigravida patients in our study with an incidence of 1.05% based on the inclusion criteria with 96.3% between the age 35-40 years. Most common reason for delayed child bearing was pursuing higher education and work preferences. Gestational hypertension was most common maternal complication (48%), associated with preeclampsia in 28%. Among fetal complications 46% had low birth weight, 38.5% had IUGR. 54% patients had delivered by LSCS.
Conclusions: Although elderly primigravida is considered a high-risk pregnancy with increased maternal and fetal complications, proper antenatal care, early recognition of maternal risk factors with timely intervention pregnancy outcome can be improved.
Barken SE, Bracken MB. Delayed childbearing: no evidence for increased Delayed childbearing: no evidence for increased risk of low birth weight and preterm delivery. Am J Epidemiol. 1987;125:101.
Montan S. Increased risk in the elderly parturient Curr Opin Obstet Gynecol. 2007;19(2):110-2.
Verma S. Advance maternal age and obstetric performance. Apollo Med Sept. 2009;6(3):258-63.
Eke AC, Eleie GU. The pregnancy outcome in elderly primigravida-5 year review. FIGO. 2009.
Cleary-Goldman J, Malone FD, Vidaver J. Impact of maternal age on obstetric outcome. Obstet Gynecol. 2005;105:983-90.
Marai W, Lakev Z. Pregnancy outcome in the elderly gravida in Addis Ababa. East Afr Med J. 2002;79(1):34-7.
Amarin VN, Akasheh HF. Advanced maternal age and pregnancy outcome. East Mediterr Health J. 2001;7(4-5):646-51.
Meenakshi ST, Agarwal A, Das V. Advanced maternal age and obstetric outcome. J Obstet Gynecol India. 2007;57,4:320-3.
Rajmohan L, Vinayachandran S, Guhan B, Sumagala D. Pregnancy outcome in women of advanced maternal age. Int Journal of Bioassays. 2013;2(9):1193-8.
Delbaere I, Verstraelen H. Pregnancy outcome in primiparae of advanced maternal age. Eur J Obstet Gynecol Reprod Biol. 2007;135:41-6.
Vercellini P, Zuliani G, Rognoni MT. Pregnancy at forty and over: a case control study. Eur J Obstet Gynecol Repro Biol. 1993;48(3):191-5.
Bavrampour H. Comparison of perception of pregnancy risk of nulliparous women inadvanced maternal age and younger age. J Midwife Womens Health. 2012;57(5):445-53.
Oboro VO, Dare FO. Pregnancy outcome in nulliparous women aged 35 or older West Afr J Med. 2007;25:65-8.
Delpisheh A, Brabin L, attia E. Pregnancy late in life: a hospital based study of birth outcomes. J Womens Health. 2008;17(6).
Ziadeh S. Maternal and perinatal outcome in nulliparous women aged 35 and older. Gynecol Obstet Invest. 2002;54:6-10.