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Related Experiment Videos

Pregnancy at forty and over: a case-control study

P Vercellini1, G Zuliani, M T Rognoni

  • 1L. Mangiagalli Department of Obstetrics and Gynecology, University of Milan School of Medicine, Italy.

European Journal of Obstetrics, Gynecology, and Reproductive Biology
|March 1, 1993
PubMed
Summary

Women aged 40 and older experienced higher rates of gestational diabetes, chronic hypertension, premature deliveries, and Cesarean sections. However, perinatal mortality remained similar compared to younger women.

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Area of Science:

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

Background:

  • Advanced maternal age (AMA), defined as 40 years or older, is associated with potential pregnancy complications.
  • Understanding the specific obstetric outcomes in this demographic is crucial for clinical management and patient counseling.

Purpose of the Study:

  • To compare obstetric prognosis in women aged 40 and older with a younger control group.
  • To identify specific antepartum and intrapartum complications and neonatal outcomes associated with advanced maternal age.

Main Methods:

  • Retrospective cohort study comparing 327 women aged >= 40 years with age-matched controls (20-30 years old).
  • Data collected on antepartum complications, delivery mode, and neonatal outcomes between 1988 and 1990.

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  • Analysis included nulliparous and multiparous subgroups.

    • Main Results:

    • Women aged >= 40 had increased rates of gestational diabetes (2.4% vs 0.3%) and chronic hypertension (3.4% vs 0.3%).
    • Premature deliveries (19% vs 8%) and Cesarean section rates were significantly higher in the older group (nulliparas: 64% vs 30%; multiparas: 43% vs 12%).
    • Low birthweight (17% vs 5%) and low 5-minute Apgar scores (8% vs 2%) were more common in infants of older mothers, primarily after Cesarean delivery.

    Conclusions:

    • Advanced maternal age is linked to increased risks of specific antepartum complications and operative delivery.
    • While Cesarean sections and low birthweight were more frequent, perinatal mortality was comparable between the age groups.
    • Neonatal outcomes for vaginally delivered infants were similar across age groups, suggesting delivery mode influences Apgar scores.