Meta Analysis of Elderly Gravida according to Postpartum Maternal, and Fetal and Neonatal Outcomes / 대한산부인과학회잡지

ABSTRACT

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.