Pregnancy at forty and over: a case-control study.
We compared obstetric prognosis in 327 women > or = 40 years old (148 nulliparas, 279 multiparas) with 20-30-year-old matched controls who delivered at our department between 1988 and 1990. Gestational diabetes and chronic hypertension were the only more frequent antepartum complications in cases than controls (2.4% vs. 0.3% and 3.4% vs. 0.3%, respectively). There were more premature deliveries in cases than controls (19% vs. 8%) but no difference in postdate deliveries. Cesarean section was more frequent in cases than controls in both nulliparas (64% vs. 30%) and multiparas (43% vs. 12%). Incidence of abdominal delivery for acute obstetrical indications was not increased in older gravidas. Significant differences were observed in low birthweight (17% vs. 5%) and 5-min Apgar score < 7 (8% vs. 2%). Most of the abnormal Apgar scores were recorded after cesarean section; values for vaginally-delivered infants were comparable in older and younger women. Perinatal mortality was similar in the two groups.
Vercellini
P
P
L. Mangiagalli Department of Obstetrics and Gynecology, University of Milan School of Medicine, Italy.
Zuliani
G
G
Rognoni
M T
MT
Trespidi
L
L
Oldani
S
S
Cardinale
A
A
D000328:Adult; D000367:Age Factors; D001034:Apgar Score; D016022:Case-Control Studies; D002585:Cesarean Section / Q000706:statistics & numerical data; D016640:Diabetes, Gestational / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007226:Infant Mortality; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008423:Maternal Age; D008875:Middle Aged; D007752:Obstetric Labor, Premature / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome; D018566:Pregnancy, High-Risk; D012307:Risk Factors