[Pregnancy and delivery in women over 40 years old]

Our purpose was to describe the maternal and fetal outcomes of pregnancies in women of 40 years or older who delivered in the Department of Gynecology and Obstetrics in Hospital of Słupsk (Poland).

We reviewed the delivery records of 98 mothers aged 40 years and above who delivered since 1st January 1999 to 31st December 2000 and we compared them with 100 younger ones (20-30 year-old) comprising the control group.

The women of 40 years or older had lower education status rate (p<0.001) and more often were cigarette smokers (p<0.001) than those of control group. The mean duration of gestation was significantly shorter in women of 40 years or older (p<0.001). The older mothers had an average of 5.1 antenatal visits, whereas the younger ones 7.5 (p<0.001). Preterm delivery was observed more frequently in the older mothers compared with controls (19% vs 5%) (p=0.002). Pregnancies in older women ended significantly more often by cesarean section than in younger women (p=0.001). The rate of cesarean section was 40% in older women compared to 19% in young mothers. Significant differences were observed at 1-min and 5-min Apgar score (p=0.02 and p=0.04). The older mothers had an average of 7.9 at 1-min Apgar score versus 9.0 of younger and 8.5 at 5-min Apgar score, whereas the younger ones 9.3.

Older pregnant women had increased risk of preterm delivery, cesarean section, and lower Apgar score. These data suggest that the prenatal care of older mothers should concentrate on the prevention of premature deliveries and the improvement of perinatal care.