ABSTRACT
Background: As women increasingly delay child bearing, the proportion of women having their first delivery at ''advanced maternal age'' is expected to rise. These elderly primigravidae have traditionally been considered to be at increased risk of adverse maternal and perinatal outcomes compared to their younger counterparts, because of associated pregnancy and labour complications. Objectives: To determine the prevalence of elderly primigravidae and compare their pregnancy outcome with that of younger primigravidae in Aminu Kano Teaching Hospital, Kano. Materials And Methods: This was a retrospective case control study comparing the pregnancy outcome of primigravid mothers aged 35 years and above (elderly primigravidae) with those of younger primigravidae aged 20-25 years, who delivered at Aminu Kano Teaching Hospital between January 2009 and December 2013. Results: There were 18,452 deliveries during the period under review, out of which 295 were primigravidae aged 35 years or above giving a prevalence of 1.6%. There was statistically significant higher preterm delivery rate ( X2= 10.30, P= 0.001) and caesarean delivery rate (X2= 12.15, P= 0.0001) among the elderly primigravidae compared to younger primigravidae. The elderly primigravidae were more prone to hypertensive disorders in pregnancy (X2=23.96, P=0.0001) and diabetes (X2=4.689, P=0.030) compared to the younger primigravidae. The prevalence of antepartum haemorrhage (X2=6.434, P=0.011) and uterine fibroids (X2=5.549, P=0.019) were also statistically significant among the elderly primigravidae compared to the younger primigravidae. There was no significant difference in the other maternal and foetal outcome measures. Conclusion: The prevalence of elderly primigravidae in this study was 1.6%. The prevalence of obstetric complications such as preterm delivery, antepartum haemorrhage, uterine fibroids coexisting with pregnancy and medical conditions like hypertensive disorders in pregnancy and diabetes mellitus are higher among elderly primigravidae compared to younger primigravidae. The elderly primigravidae were also more liable to have caesarean deliveries than the younger primigravidae. However there was no difference in the fetal outcome in the two groups
Subject(s)
Gravidity , Nigeria , Obstetric Labor Complications , Pregnancy Outcome , Premature Birth , PrevalenceABSTRACT
Objectives. To determine the changes in stillbirth rates in singleton pregnancies in a stable population over a period of 50 years. Methods. Stillbirth rates for singleton pregnancies where the fetus weighed 1 000 g or more were collected from 1962 to 2011. From 1972 to 2011; rates included fetuses weighing 500 g or more at birth. Results. When the birth weight was 1 000 g or more the stillbirth rate declined from 70 to 12.6 per 1 000 births; and when the birth weight was 500 g or more it dropped from 34.2 to 24.5. The decline was very much slower towards the end of the study period. Conclusion. To achieve further sustained reductions in stillbirth rates; healthcare workers should continue to emphasise quality of healthcare; but they should also address and prevent specific conditions associated with stillbirth; such as smoking and drinking during pregnancy