Fertility, conception and complications in elderly primigravidas a comparative study: observational study


  • Madieha Sabha Department of Obstetrics and Gynecology, Sher-i-Kashmir Institute of Medical Sciences, SKIMS, Soura, Srinagar, Jammu and Kashmir, India
  • Khushbu Bashir Department of Obstetrics and Gynecology, Sher-i-Kashmir Institute of Medical Sciences, SKIMS, Soura, Srinagar, Jammu and Kashmir, India




Primigravida, Foetal complications, ART, C-section


Background: Incidence of elderly primigravida has increased now days, due to rising education level, effective means of birth control and high carrier goals. The women who conceived at advanced age (>35 years) for first time is defined as elderly primigravida. Indian standard is fixed at more than 30 years by Dutta 2013. These women are high risk for maternal and foetal complication and outcome. The study was done to assess pregnancy outcome in elderly primigravida.

Methods: This was a prospective comparative study done in 180 patients over a period of 18 months from September 2017 to March 2019. Among 180 patients 90 patients were elderly primigravidas more than 30 years of age and 90 patients were young primigravidas aged 20 to 29 years.

Results: Majority of elderly women though married early, conceived late, many women required other ovulation induction to ART dueto many associated complication with elderly primigravida C-section rate is higher in elderly as compared to vaginal delivery.

Conclusions: Elderly primigravida >30 years old had more difficulty in conceiving spontaneously as the fecundity is less with advanced age. The need for ovulation induction and other artificial reproductive techniques is higher in women with advanced age. The complications during pregnancy, labour and postpartum is higher in elderly primigravidas as compared to women less than 30 years of age.


Tuck M, Yudkin PL, Turnbull AC. Pregnancy outcome in elderly primigravidae with and without a history of infertility. BJOG. 1988;95(3):230-7.

Dutta DC, Textbook of Obstetrics. 7th edition. New Delhi: Jaypee Brother Medical Publisher (p) Ltd. 2013;22:341.

Barton JR, Bergauer NK, Jacques DL, Coleman SK, Stanziano GJ, Sibai BM. Dose advanced maternal age affect pregnancy outcome in women with mild hypertension remote from term? Am J Obst Gynae. 1997;176(6):1236943.

Anate M, Akeredolu O. Pregnancy outcome in elderly primigravida at University of llorin Teaching Hospital, Nigeria. East African Med J. 1996;73(8):548-51.

Bianco A, Stone J, Lynch L, Lapinski R, Richard L. Pregnancy outcome at age 40 and older. Obstet Gynecol. 1996;87(6):917-22.

Chan BCP, Lao TT. Influence of parity on the obstetric performance of mothers aged 40 years and above. Human Repro. 1999;14(3):833-7.

Urquhart DR, Tai C. Obstetric performance in the elderly Malaysian primigravida. Asia Oceania J Obstet Gynecol. 1991;17(4):321-5.

Scholz HS, Haas J, Petru E. Do primiparas aged 40 years or older carry an increased obstetric risk. Prevent Med. 1999;29(4):263-6.

Ales KL, Druzin ML, Santini DL. Impact of advanced maternal age on the outcome of pregnancy. Surg Gynaecol Obstet. 1990;171(3):209-16.

Dutta PC. Elderly primigravidae. BJOG. 1948;55(1):68-70.

Van Noord BM, Zaadstra CW, Looman, Halsbach, JD, Habbema ER, Karbaat J. Delaying child bearing; effect of age on fecundity and outcome of pregnancy. Br Med J. 1991;302:1361-4.

Young JH. Age and parturition in primigravidae. BJOG. 1963;70(4):636.






Original Research Articles