Obstetric outcome in first-time mothers aged 40 years and over

This retrospective study examines the outcome of pregnancy after 28 weeks gestation in 100 consecutive, unselected primiparae who were aged 40 years or more. Antenatally, the incidence of hypertension was increased. There was an increased incidence of induction of labour and caesarean section. There were no maternal deaths and no evidence of an increase in maternal morbidity. After correction for congenital malformations, the perinatal mortality rate was not increased in these mothers. The incidence of Down's Syndrome was 4%, as expected. In general, the outcome of the pregnancy for the mother and her baby was satisfactory. Contrary to popular opinion, the results justify an optimistic approach to women about to become mothers for the first time in their forties, and the traditional high intervention rates may not be justified.