Observational Study of Maternal and Fetal Outcome in Elderly Primigravida

Background Maternal age plays an important role in determining pregnancy outcome and women aged 35 years and above undergoing their first pregnancy are often classified under high risk pregnancy group. Objective The objective of this study was to determine the maternal and fetal outcome in an elderly primigravida. Material and Methods Case records of 4167 pregnant women were reviewed retrospectively. Primigravidas with age more than 35 years old at the time of delivery were included in the study. Data regarding age, socioeconomic status, booking status, mode of delivery, maternal and foetal complications were collected. Results During the study period, there were 4167 deliveries out of which 80 were elderly primigravidae giving the incidence of 1.9 %. Increased maternal complications like hypertensive disorder in pregnancy (22.5 %), gestational diabetes mellitus (7.5 %), anemia (7.5 %), hypothyroidism (6 %), oligohydramnios (5 %) were seen. Increased fetal complications like IUGR (13 %), preterm delivery (6 %), anomalies (4 %) and intrauterine fetal demise (4 %) were seen. Caesarean section rate was 56 %. Conclusions Despite technological advancements, the rates of maternal and fetal morbidity and mortality remain high in advanced maternal age. We believe that with advent of preconceptional counselling, prenatal diagnosis and antepartum fetal surveillance, maternal and fetal morbidity and mortality can be reduced.