Performance of elderly primigravidae in Kelantan

Area of Science:

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

Background:

• Advanced maternal age is increasingly common in many parts of the world.
• Understanding obstetric risks associated with advanced maternal age is crucial for improved maternal and infant care.
• Primigravidae at advanced maternal age represent a specific subgroup requiring focused obstetric evaluation.

Purpose of the Study:

• To compare the obstetric performance of elderly primigravidae with that of younger primigravidae.
• To identify specific complications associated with advanced maternal age in first-time mothers.
• To evaluate neonatal outcomes in relation to maternal age at first childbirth.

Main Methods:

• Retrospective cohort study comparing two groups of primigravidae (elderly vs. young).
• Data collected from deliveries at University Hospital, Kelantan, between January 1987 and December 1988.
• Obstetric complications and neonatal outcomes were analyzed and compared between the groups.

Main Results:

• Elderly primigravidae showed a significantly higher incidence of preeclampsia (23.7% vs. 13.3%) and breech presentation (6.78% vs. 3.33%).
• Caesarean section rates were markedly higher in the elderly group (74.6% vs. 10%), primarily due to poor labor progress and fetal distress.
• No statistically significant differences were observed in neonatal outcomes, including birthweight, gestational age, and breastfeeding at discharge.

Conclusions:

• Advanced maternal age in primigravidae is associated with increased risks of preeclampsia, breech presentation, and Caesarean delivery.
• Despite increased obstetric interventions, neonatal outcomes appear comparable between elderly and young primigravidae.
• These findings underscore the need for vigilant monitoring and management of pregnancies in elderly primigravidae.