Pregnancy outcome in elderly primigravidae.

BACKGROUND As women increasingly delay child bearing, the proportion of women having their first delivery at ''advanced maternal age'' is expected to rise. These elderly primigravidae have traditionally been considered to be at increased risk of adverse maternal and perinatal outcomes because of associated pregnancy and labor complications and, therefore, need to be evaluated. AIM To determine the prevalence of elderly primigravidae and compare their pregnancy outcome with that in younger primigravid mothers in Port Harcourt. MATERIALS AND METHODS It was a two-year retrospective case-controlled study. The study population consisted of all primigravid mothers aged 35 years and above (elderly primigravidae) who delivered at the University of Port Harcourt Teaching Hospital (UPTH) between 1st January, 2005 and 31st December 2006, and the control group consisted of all other primigravid women less than 35 years of age. Selected maternal and perinatal sociodemographic characteristics and other outcome variables were extracted from patients' case notes. The data were entered into a personal computer and analyzed using SPSS version 11.0. The χ2 - test was used for comparison of both groups and statistical significance set at P < 0.05. RESULTS Of the 5147 parturients who delivered during the study period, 74 (1.4%) were elderly primigravidae. They constituted 4.7% of all primigravidae. The caesarean delivery rate (58.1% vs 32.1%, P = 0.001), preterm delivery rate (10.8% vs 5.1%, P = 0.03), and fetal macrosomia rate (16.2% vs 6.6%, P = 0.002) were significantly higher in the elderly primigravidae than the younger primigravid controls. There were no significant differences in the other maternal and perinatal outcome measures. CONCLUSION The prevalence of elderly primigravidae in our centre is 1.4%. The elderly primigravidae are at increased risk of preterm, macrosomic, and caesarean deliveries compared to their younger primigravid counterparts.