Elderly primigravida and a comparative analysis of their pregnancy outcome with younger primigravida
Keywords:Elderly primigravida, Obstetric outcome
Background: Though pregnancy and child birth is a normal physiological process but a woman with advanced age is a risk factor for adverse pregnancy outcome. This study was conducted to find out the proportion of elderly primigravida and to compare their pregnancy outcome with that in younger primigravida of aged 20-25yrs.
Methods: A retrospective study was carried out over a period of two years in a tertiary care hospital of Meghalaya. Secondary data on obstetrics outcome of 54 elderly primigravida aged ≥35 years (study group) was compared to 120 younger primigravida (control group) of aged 20-25 years, delivered during the period of study. The chi square test and Fisher’s exact test were used for statistical analysis and p value of <0.05 was taken as level of significance.
Results: During two years of study period, 2048 patients had delivered, out of which 411 (20.1%) were primigravida, 54 (2.6%) were elderly primigravida, 120 (5.9%) were in the younger age groups and 66 (3.2%) were teenage pregnancy. Pregnancy induced hypertension (PIH) with preeclampsia 12 (22.2%), preterm labour 2 (3.7%), instrumental delivery 6 (11.1%), caesarean section 32 (59.3%) were found significantly higher in study group.
Conclusions: In our study, the prevalence of elderly primigravida was 2.6% and they had high rates of complications during antenatal period and course of labour than younger primigravida.
Shehadeh A. Elderly primigravida and pregnancy outcome. JRMS. 2002;9(2):8-11.
Rajmohan L, Vinaychandran S, Guhan B, Sumangala Devi D. Pregnancy outcome in women of advanced maternal age. International J Bioassays. 2013;02(09):1193-8.
Chloe V, Fretts R. Pregnancy and advanced maternal age. In: Studd J, Lintan S, Chervena KF editors. Progress in Obstetrics and Gynaecology. 17th ed. Philadelphia: Elsevier publishers;2006:113-24.
American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 27: Clinical Management Guidelines for Obstetrician-Gynecologists. Prenatal diagnosis of fetal chromosomal abnormalities. Obstet Gynecol. 2001;97:1-12.
Ziadeh SM. Maternal and perinatal outcome in nulliparous women aged 35 and older. Gynecol Obstet Invest. 2002;54(1):6-10.
Seoud MA, Nassar AH, Usta IM, Melhem Z, Kazma A, Khalil AM. Impact of advanced maternal age on pregnancy outcome. Am J Perinatol. 2002;19(1):1-8.
Oboro VO, Dare FO. Pregnancy Outcome in nulliparous women aged 35 years and older. West Afr J Med. 2006;25:65-8.
Ojule JD, Ibe VC, Fiebai PO. Pregnancy outcome in elderly primigravidae. Annals African Med. 2011;10(3):204-8.
Chan BC, Lao TT. Influence of parity on the obstetrics performance of mothers aged 40 years and above. Hum Reprod. 1999;14(3):833-7.
Naqvi MM, Naseem A. Obstetrical risks in the older primigravidae. J Coll Physicians Surg Pak. 2004;14:278-81.
Ilesanmi AO, Fawole O, Olaleye DO, Arowojolu A. Pregnancy outcome in the Elderly primigravidae. J Obstet Gynaecol. 1998;18:40-3.
Sahu T Meenakshi, Agarwal A, Dasvinila. Queen Mary Hospital J Obstet Gynaecol India. 2007;57:320-3.
Jacobson B, Ladfors L, Milsom I. Advanced maternal age and adverse perinatal outcome. Obstet Gynecol. 2004;104:727.
Yerushalm YJ. The classification of new born infants by birthweight and gestational age. Paedia 1963;32:800-5.
Ezra Y, Part MC, Farine D. High delivery intervention rates in nulliparous women. Euro J Obstet Gynaecol. 2007;19:110-2.