Obstetric outcome in elderly gravida

Supriya S. Gaikwad, Kamlesh R. Chaudhari, Karuna Batheja


Background: Maternal age is an important determinant of the outcome of pregnancy. Advanced maternal age generally signify age after 35 years at the time of delivery. It is associated with decreased fertility and increased risk. Elderly gravida is associated with many complications during pregnancy, labour and also for the baby. In recent times women has changed their lifestyles such as pursuit of higher education and entry into work forces and career advancement outside the home.

Methods: This was a retrospective study done in 57 elderly pregnant women more than 33 years age, over a period of 18 months, conducted in a multi-specialty hospital.

Results: 57 elderly pregnant women were selected for the study. 47% were in age group of 33-35 years and 42% were in age group of 36-40 years. 61.40% patients were housewives and 38.59% were employed. 50.8% of patients had history of previous abortions and 35% were conceived after treatment for sterility. 64.9% of patients conceived spontaneously and 35% by assisted reproductive technology. Majority of patients (33.3%) required Invitro-fertilization. Multiple pregnancy was high- 21.05%. Hypertension was observed in 26.3% of patients, Antepartum haemorrhage in 4.34%,  Preterm delivery  49.1%, Induction of labour in 10.52%, Normal vaginal delivery only in14%. Majority of patients (80.7%) were delivered by caesarean section.

Conclusions: Elderly pregnant patients have higher risks of specific pregnancy complications which contribute to a higher frequency of maternal morbidity and greater health care costs. The risks are due to Hypertension, diabetes, multiple pregnancy, preterm labour, antepartum haemorrhage, PROM, malpresentation, prolonged labour, increased caesarean section rate and postpartum haemorrhage.


Assisted reproductive technology, Antepartum haemorrhage, Elderly gravida, Multiple pregnancy, Preterm delivery

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Nathanson JN. A parallel study of labor in young and old primiparas: Based upon a critical analysis of 372 cases below twenty and above thirty-five years of age. Am J Obstet Gynecol. 1935;30(2):159-73.

Rucker MP. Mono-amniotic twins: With both umbilical cords about the first twin's neck. Am J Sur. 1935;28(1):175-6.

Young, J. Relaxation of the pelvic joints in pregnancy: pelvic arthropathy of pregnancy. J Obstet Gynaecol Br Emp. 1940;47(5):493-524.

Laxmy R, Beena G. Pregnancy outcome in women of advanced maternal age. Int J Bioassays. 2013; 2(9):1193-8.

Paulson RJ, Boostanfar R, Saadat P, Mor E, Tourgeman DE, Slater CC, Francis MM, Jain JK. Pregnancy in the sixth decade of life: obstetric outcomes in women of advanced reproductive age. Jama. 2002;288(18):2320-3.

Tebeu PM, Kouam L, Nghonguia MF, Obama MT, Major AL, Ludicke F(2007). [historical cohort study of delivery in women of forty years of age and older]. Rev Med Liege;62(7-8):509-14.

Krieg SA, Henne MB, Westphal LM. Obstetric outcomes in donor oocyte pregnancies compared with advanced maternal age in in vitro fertilization pregnancies. Fertil Steril. 2008;90(1):65-70.

Luke B, Brown MB. Elevated risks of pregnancy complications and adverse outcomes with increasing maternal age. Human Reproduct. 2007;22(5):1264-72.

Marai W, Lakev Z. Pregnancy outcome in the elderly gravida in Addis Ababa. East African Med J. 2002;79(1):34-7.

Nojomi M, Haghighi L, Bijari B, Rezvani L, Tabatabaee SK. Delayed childbearing: pregnancy and maternal outcomes. Iranian J Reproduct Med. 2010;8(2).

Paulson RJ, Boostanfar R, Saadat P, Mor E, Tourgeman DE, Slater CC, Francis MM, Jain JK. Pregnancy in the sixth decade of life: obstetric outcomes in women of advanced reproductive age. Jama. 2002;288(18):2320-3.

Salihu HM, Shumpert MN, Slay M, Kirby RS, Alexander GR. Childbearing beyond maternal age 50 and fetal outcomes in the United States. Obstet Gynecol. 2003;102(5):1006-14.

Fitzpatrick KE, Tuffnell D, Kurinczuk JJ, Knight M. Pregnancy at very advanced maternal age: a UK population‐based cohort study. BJOG: An International J Obstet Gynaecol. 2017;124(7):1097-106.

Moses V, Dalal N. Pregnancy outcome in elderly primi gravidas. Int J Reprod Contracept Obstet Gynecol. 2016;5(11):3731-55.

Porreco RP, Harden L, Gambotto M, Shapiro H. Expectation of pregnancy outcome among mature women. Am J Obstet Gynecol. 2005;192(1):38-41.

Yogev Y, Melamed N, Bardin R, Tenenbaum-Gavish K, Ben-Shitrit G, Ben-Haroush A. Pregnancy outcome at extremely advanced maternal age. Am J Obstet Gynecol. 2010;203(6):558-e1.

Ezechi OC, Kalu BK, Loto OM, Ezeobi PM, Nwokoro CA. Obstetric performance in elderly Nigerian women: A comparative study. Nepal J Obstet Gynaecol. 2007;2(1):9-12.

Shehadeh A, Elderly primigravida and pregnancy outcome. JRMS. 2002;9(2):8-11.

Rajput N et al. Int J Reprod Contracept Obstet Gynecol. 2018;7(10):3941-5

Wang Y, Tanbo T, Åbyholm T, Henriksen T. The impact of advanced maternal age and parity on obstetric and perinatal outcomes in singleton gestations. Arch Gynecol Obstet. 2011;284(1):31-7.