[Particularities of pregnancy and labor in 40 - year-old women about 300 cases]

ABSTRACT

Pregnancy beyond age 40 is considered as a high risk pregnancy associated with high rates of maternal and fetal complications. To analyze particularities of pregnancy and labor and to examine obstetrical and neonatal outcomes among women age 40 years and older. There was a retrospective study including two groups of 300 patients, the first including the 40-year-old and over women [case group], and the second including 20-to 39 -year-old mothers [control group]. The mean age for the case group was 41 years. Ten [10.6%] of the women in the case group were primiparous as compared with twenty-seven [27.5%] in the control one [p=0.001]. The antenatal surveillance was better in the control group. The morphologic sonography was performed in 73% of cases of 40-year-old-women versus 90% in the control group [p<0.001]. Maternal age 40 and over was associated with an increased risk for gestational diabetes [6.4% versus 1.7%, p<0.001]. The premature rupture of membranes was frequent in the case group [25.7% versus 11.7% p<0.001], and the amniotic fluid meconuim [16.3% versus 6.7%, p<0.001]. The risk for cesarean section was higher in older women [25.7% versus 14% avec p<0.001]. Neonatal outcomes [Apgar score, birth weight, perinatal mortality] were similar to those in the younger age group. The analysis of our results and the review of the literature have proven that advanced-maternal-age pregnancy is associated with increased complications. So more recommendations' are necessary to ameliorate the management of this pregnancy