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Obstetrical performance in elderly Zambian parturients

S Wadhawan, R K Narone, J N Narone

    Medical Journal of Zambia
    |February 1, 1981
    PubMed
    Summary
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    Elderly mothers (40+) had a 1.0% incidence of delivery. Despite high rates of complications and operative deliveries, no maternal deaths occurred, though perinatal outcomes were poor.

    Area of Science:

    • Obstetrics and Gynecology
    • Maternal-Fetal Medicine
    • Public Health

    Background:

    • Advanced maternal age (40 years and above) is associated with increased obstetric risks.
    • Understanding the delivery outcomes for elderly parturients is crucial for improving maternal and infant care.
    • Limited data exists on the obstetric performance of elderly mothers in low-resource settings.

    Purpose of the Study:

    • To analyze the obstetrical performance of elderly parturients (aged 40 and above).
    • To determine the incidence of advanced maternal age deliveries and associated complications.
    • To evaluate fetal outcomes in this high-risk maternal group.

    Main Methods:

    • Retrospective analysis of delivery data from University Teaching Hospital, Lusaka.

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  • Inclusion criteria: mothers aged 40 and above delivering between 1979-1980.
  • Data collected on maternal characteristics, pregnancy complications, delivery mode, and fetal outcomes.
  • Main Results:

    • Incidence of deliveries by mothers aged 40+ was 1.0% (391/39,109).
    • 87.2% were grand multipara; 22% required operative delivery (13% Cesarean, 9% operative vaginal).
    • High rates of prematurity (71/1,000) and perinatal death (138/1,000) observed; no maternal deaths recorded.

    Conclusions:

    • Elderly parturients in this setting present with high parity and require significant operative intervention.
    • While maternal mortality was zero, adverse perinatal outcomes necessitate targeted interventions.
    • Further research on preventable factors related to maternal age and parity is warranted.