ABSTRACT
Based on the 10 domestic theses which conducted a case-control study of elderly gravida over 35, meta analysis was made of the general and clinical characteristics of cases of elderly gravida over 35 and controls of gravida under 35 with the following result. The percentage of elderly primipara was 0.5 to 2.0 according to a researcher, and that of elderly gravida 3.3 to 4.5. The percentage of elderly primipara and elderly gravida tended to be in reverse proportion to school career. Elderly gravida was found to have twice as many experiences of spontaneous abortion and the same was true of induced abortion. The ratio of cases of controls in antepartum risk factors are as follows: Finally, it should be admitted that there are some problems in this study such as biased selection, the lack of clear operational definition, the lack of precise P-value, omitted standard deviation and uncontrolled confounding variables.
Subject(s)
Aged , Female , Humans , Pregnancy , Abortion, Induced , Abortion, Spontaneous , Bias , Case-Control Studies , Risk FactorsABSTRACT
Based on the 10 domestic theses which conducted a case-control study of elderly gra-vida over 35, meta analysis was made of the postpartum maternal outcome and fetal-neon-atal outcome with elderly gravida over 35 as cases and with gravida under 35 as controls. The findings are as follows: As for fetal-neonatal outcomes, the frequency of low birth weight was twice as high for cases , compared with controls, intrauterine growth retardation 2.4 times as high, macrosomia about 30% higher , congenital anomaly 16% higher , intrauterine fetal death 2.6 times as high, admission to newborn intensive care unit twice as high , and perinatal mortality twice as high. In case of neonatal sex , cases produced 28% more male babies than controls. As for postpartum maternal outcomes , the frequency of cesarean delivery was 2.9 times as high, compared with controls and postpartum hemorrhage 62% higher. Vaginal wall laceration, 3rd degree laceration, 4th degree laceration and cervix laceration all didn`t happen to cases as frequently as controls, while postpartum anemia was observed in cases 2.3 times as often as controls, wound infection 57% more often , bladder dysfunction 32% more , urinary tract infection 72% more and DIC about twice as often. In case of postpartum cardiomyopathy, pulmonary edema, respiratory infection, hepatitis and sepsis respectively, cases showed 7.4 times higher rate of an attack. Finally , it should be admitted that there are some problems in this study such as controversial hospital data used in analysis, the lack of clear operational definition , the lack of precise P-value, omitted standard deviation and uncontrolled confounding variables.