Problems of Older Maternal Age and Pregnancy Outcome

Results: Thirty one thousand and eight hundred women delivered during the study period. One thousand two hundred and seventy two (4%) women were age 40 or older, of which 1202 (3.7%) were included this study, of these 254 (21%) were nullipara. The cesarean delivery rate for these patients was 42.0%, while multipara women it was 26.0%. In the control group cesarean rate was 19.5% for nullipara and 12.8% for multipara women. In the older age group the operative vaginal delivery rate was 11.2% for nullipara and 4.6% for multipara women compared to 5.3% and 2.0% respectively among the younger group. The following rates were significantly higher among older nulliparas: asphyxia 5%, growth retardation 2%, malpresentation 7% and gestational diabetes 6% compared with younger nullipara controls (2.5, 1, 2.5, 1.8% respectively). There was similar significant increase among older multipara compared with younger multipara controls. Birth weight of infants delivered by older nullipara women were significantly lower than that among younger nullipara controls (P<.01). However, mean birth weight in the group of older multipara was no different than that of younger multipara controls. Gestational age at delivery was significantly lower among older nullipara, compared with younger nullipara controls (P<.01), and similarly lower among older multipara, compared with multipara controls.