Particularities of pregnancy and labor in 40 -year-old women About 300 cases

Abstract

Background: Pregnancy beyond age 40 is considered as a high risk pregnancy associated with high rates of maternal and fetal complications.
Aim: To analyze particularities of pregnancy and labor and to examine obstetrical and neonatal outcomes among women age 40 years and older.
Methods : 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).
Results: The mean age for the case group was 41 years. Ten (10.6%) of the women in the ca se 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 sonograhy 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.
Conclusion: The analysis of our results and the review of the literature have proven that advanced-maternal-age-pregnancy is associated with increased complications. So some recommendations’ are necessary to ameliorate the management of this pregnancy.