The Effects of Maternal Age on Outcome of Pregnancy in Healthy Elderly Primipara / 대한주산의학회잡지

ABSTRACT

PURPOSE:To investigate the pregnancy outcomes associated with delayed first childbearing METHODS:We evaluated retrospectively the clinical characteristics and pregnancy outcomes in primiparous mothers who delivered a fetus after more than 21 weeks of gestation in our hospital from January 2001 to December 2008. We enrolled only healthy primiparous mothers who have no underlying cardiovascular disease, hypertensive disorders complicating pregnancy and overt or gestational diabetes to remove the confounding factors which influence the pregnancy outcomes. Finally, 235 mothers aged 35 years and above and 1571 mothers aged 20~34 years were included in the study and the control groups, respectively. RESULTS:There were no differences in gestational age and birth weight between two groups. There was significantly higher incidence of cesarean section in the study group. (60.4% vs 39.4%, P= 0.000) The incidence of previous uterine operation history and placenta previa which were the indications of cesarean section were higher in the study group (3.0% vs 0.2%, P=0.000, 9.4% vs 5.2%, P=0.011). Antepartum and postpartum complications with the significantly higher incidence rates in study group were placenta previa and uterine myoma (6.0% vs 2.8%, P=0.010, 4.7% vs 1.2%, P=0.000) and wound complications (1.7% vs 0.3%, P=0.005), respectively. On the other hand, the neonatal outcomes and other antepartum/postpartum complications, such as the incidence of preterm labor, PROM and postpartum bleeding, of two groups were comparable (no significant differences were noted). CONCLUSION:Although incidence of placenta previa, cesarean section, uterine myoma and wound complication were higher in healthy old primiparous mothers, no differences were noted in neonatal outcomes compared to the young primiparous mothers. We conclude that elderly primiparous pregnancy in woman should not be considered as a high risk pregnancy on the basis of age alone.