Published: 2019-07-26

Maternal and neonatal outcome in pregnancy at 40 years and beyond in a tertiary care center: a retrospective case control study

Vrunda Appannagari, Divya K., Beena Kingsbury, Swati Rathore, Jiji E. Mathews, Mahasampath Gowri


Background: Obstetric outcome in women with advanced maternal age (AMA) is not usually studied especially in India.

Methods: This study was a case control study. The cases were pregnancy in 100 women at 40 years of age and beyond and there were two control arms of 100 each of ages 20-29 years and 30-39 years. The demography, maternal complications, delivery outcomes and neonatal outcomes were compared.

Results: Women with AMA were mostly multiparous and had higher Body Mass Index (BMI). Hypertensive disease in pregnancy was more common in AMA but the difference was statistically significant. Women with AMA were more likely to have gestational diabetes (p ≤0.011), more likely to have anemia (p=0.038), more likely to have preterm birth (p=0.001), other medical complications compare to the control group (p=0.005). They were also more likely to have Lower Segment Caesarean Section (LSCS) (p ≤0.001) and have postpartum complications. The birth weight of the neonate was significantly decreased in the AMA group (p <0.001). The neonates were also more likely to be admitted to Neonatal Intensive Care Unit (NICU) (p ≤0.006).

Conclusions: Adverse maternal and neonatal outcomes were seen despite individualized and optimal obstetric care. Thus, these women need preconceptional counselling.


Advanced maternal age, Assisted conception, Delivery outcomes, Elderly women, Neonatal outcomes, Pregnancy

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