Pregnancy outcome in elderly primi gravidas

Vibha Moses, Nilesh Dalal


Background: The health of the mother lays a strong foundation to the health of the nation in general. Pregnancy and child birth are normal physiological processes and outcomes of most pregnancies are good. But pregnancy in woman with advanced age is considered high risk. In obstetric practice, maternal age is an important determinant of the outcome of pregnancy. One such risk factor is an elderly pregnancy that leads to many complications during pregnancy, labor and also for the baby. Elderly Primi Gravida - Women who become pregnant first time after the age of 35 years. In recent times women have changed their life style such as in the pursuit of higher education and entry into work forces and career advancement outside the home. Consequently, this has lead to postponement of child bearing, resulting in an increasing maternal age and it contributes to this upward trend. This study was designed to assess pregnancy outcomes in elderly primigravidas.

Methods: This study was a Prospective hospital based study done in 100 elderly primigravida enrolled after exclusion criteria in M. Y. Hospital and Kalyanmal Nursing Home, MGMMC Indore during Jan. 2015 to Dec. 2015.

Results: This study showed 38% women postponed their pregnancy due to education and increased maternal complications like Gestational hypertension develop in 24% elderly primigravida. Gestational diabetes mellitus in 6%, anemia in 19%. Antepartum haemorrhage in 3%. Cesarean section rate 40%. Preterm vaginal delivery 17%. Induction of labour in 11% and normal delivery only in 29% and congenital anomaly 3%.

Conclusions: Elderly women are at a high risk of several complications including instrumental deliveries, mal-presentations, mal-positions, prolonged labor, increased caesarean section rate, induction of labor, pregnancy induced hypertension, diabetes mellitus, ante and post partum hemorrhage. It was concluded that among maternal pregnancy outcomes PPH, Induction of labour and cervical dystocia were found significantly more in elderly primi gravida, fetal pregnancy outcomes such as, Oligohydramnios, Breach and Transverse lie were found significantly more in elderly primigravida. Likewise vaginal deliveries were significantly less in elderly primi gravida. IUGR and low birth weight was significantly higher in newborns of elderly primi gravida.


Elderly primigravida, Pregnancy, Maternal complication

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Obed SA, Armah JO, Wilson JB. Advanced maternal age and pregnancy. West Afr J Med. 1995;14(4):198-201.

Morrison, I. The elderly primigravida. American Journal of Obstetrics and Gynecology. 1974;121,465-70.

Lavin ER, Samuel H. Wood Essential over 35 Pregnancy guide. 1998.

Montan S. Increased risk in the elderly parturient Curr Opin Obstet Gynecol. 2007;19(2):110-2.

Van Katwijk C, Peeters LL. Clinical aspects of pregnancy after the age of 35 years. Hum Reprod Update. 1998;4(2):185-94.

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.

Laxmy R, Vinayachandran S, Guhan B, Sumangala DD. Pregnancy Outcome In Women Of Advanced Maternal Age. International Journal of Bioassays. ISSN: 2278-778X.

Naqvi MM, Naseem A. Obstetrical risks in the older primigravida. J Coll Physicians Surg Pak. 2004;14(5):278-81.

Luke B, Brown MB. Elevated risks of pregnancy complications and adverse outcomes with increasing maternal age. Hum Reprod. 2007;22.

Grimes, David A, Gross, Gail K. Pregnancy Outcomes in Black Women Aged 35 and Older obs and gynecology. 1998.

Joseph KS, Allen AC, Dodds L, Turner LA, Scott H, Liston R. The Perinatal Effects of Delayed Childbearing. Obstet Gynecol. 2005;105:1410.

Nelson. Risk of hypertension as age advances. Br J Obstet Gynecol. 1995;23:169.

Ziadeh S. Maternal and perinatal outcome in nulliparous women aged 35 and older. Gynecol Obstet Invest. 2002;54:6-10.

Bavrampour H. Comparison of perception of pregnancy risk of nulliparous women in advanced maternal age and younger age. J Midwifery Womens health. 2012;57(5):445-53.

Llesanmi AO, Fawole O, Olaleye DO, Arowojolu A. Pregnancy outcome in the elderly primigravidae. J Obstet Gynaecol. 1998.

Delpisheh A, Brabin L, Attia E, Brabin BJ. Pregnancy late in life: a hospital- based study of birth outcomes. J Womens Health. 2008.