Delivery at 40 years of age and over

This is a retrospective review of 494 deliveries during a 10-year period in women aged 40 or more years. A decline in the incidence of deliveries in this age group was noted, from 2.1% in 1965 to 1.2% in 1974. An increased frequency of complications during pregnancy and delivery, a high rate of cesarean sections, and increased perinatal mortality rate, and more congenital malformations were recorded as compared with both a control group of randomly selected grand multiparas and a general obstetric population group of patients under the age of 40 years. The fetal outcome improved during the last years of the study; the perinatal mortality rate dropped from 10.4% in 1965 to 1.6% in 1973 to 0% in 1974. This achievement reflects the significant progress in obstetrics that has been made during these years.