Perinatoloji Dergisi 2004; 12(4): 179-183
Online published date : 1 March 2005

Pregnancy at forty and over : retrospectıve analysıs of ten years perıod

 
Serap ÖZÇELİK, Ahmet KALE, Osman KARAMAN, Gökhan BAYHAN, Murat YAYLA
 
Dicle Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Anabilim Dalı, Diyarbakır.
 

Objective: Our purpose was to compare the clinical findings of pregnancies in women at 40 years age and over, which known as high-risk pregnancies, and pregnancies between 35-39 years old at the same time period

Methods: In this retrospective study, we reviewed our birth and discharge reports of both mother and newborn of all deliveries that occurred in Dicle University School of Medicine, Department of Obstetrics and Gynecology in Diyarbakır between January 1, 1994, and January 1, 2004. The study population consisted of all women who delivered at age 40 or over (n=640). The control population was consisted of women who delivered between age 35 and 39 years during this 10 years period (n=640). All the cases in the control group were selected randomly, without knowledge of pregnancy or perinatal outcomes. Two groups were matched according to the mode and type of delivery, birth weight, Apgar scores, perinatal mortality rates, gestational age at delivery, parity, fetal anomaly and maternal medical conditions (preeclampsia, diabetes mellitus, preterm labour, preterm premature rupture of the membranes, placenta previa, and placental abruption.

Results: Incidence of a woman who delivered at age 40 or over was 4.76%. Mean median age was 42.01±2.42, multiparity 95%, gravida 9.17±2.42, parity 7.39±2.34 respectively in the study group. Mean median age was 37.05±1.98, multiparity 92%, gravida 8.98±1.91, parity 7.15±2.12 in the control group. Mean gestational age was not different between two groups (p>0.05). The most frequent cesarean indication was previous cesarean (46.09%) in the study group, and fetal distress in the control group. Mean birth weight, low birth weight, very low birth weight, 1st and 5th minutes Apgar scores, perinatal mortality rates and fetal anomaly rates were not different between two groups (p>0.05). Diabetes mellitus, preeclampsia, eclampsia, chronic hypertension, abruptio placenta, and placenta previa were found high in the study group (p<0.05), preterm labour and preterm premature rupture of membranes were found high in the control group (p<0.05).

Conclusion: Pregnancies at 40 years and over were confronted late in their reproductive period in our area, since the contribution in family planning was insufficient. Some complications such as placenta previa and placental abruption, and some maternal diseases such as diabetes mellitus and hypertension were found high in 40 years age and over group. Advising hospital deliveries has a chance to prevent some of the related complications.

 
Keywords

Pregnancy at forty and over, Perinatal risk.