title: Obstetric outcome of elderly low-risk nulliparae.
abstract: OBJECTIVE
  To compare referrals and reasons for referral during pregnancy and labor, mode of delivery and obstetric outcome of first births in women 35 years and older with women 20-30 years old.
  
  
  METHODS
  A prospective cohort study was performed of 146 elderly and 306 younger nulliparae in seven independent midwives' practices in and around Amsterdam.
  
  
  RESULTS
  No significant differences in referrals were found between the two compared groups. After selection during pregnancy, obstetric outcome was not different between the groups. A higher percentage of episiotomies was found in the elderly group, compared to the younger group.
  
  
  CONCLUSIONS
  After proper selection during pregnancy, the elderly nullipara under the care of a midwife does not have an increased risk of fetal distress or other emergency factors, compared to the younger nullipara. However, high referral rates during labor - both of younger and older women - were observed in this study.
authors.affiliation: Academic Medical Center, University of Amsterdam, The Netherlands. y.smit@amc.uva.nl
authors.forename: Y
authors.initials: Y
authors.lastname: Smit
authors.forename: S A
authors.initials: SA
authors.lastname: Scherjon
authors.forename: M
authors.initials: M
authors.lastname: Knuist
authors.forename: P E
authors.initials: PE
authors.lastname: Treffers
mesh_terms: D000328:Adult; D000367:Age Factors; D001724:Birth Weight; D015331:Cohort Studies; D005260:Female; D005313:Fetal Death; D006801:Humans; D015994:Incidence; D007226:Infant Mortality; D007231:Infant, Newborn; D008423:Maternal Age; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D007744:Obstetric Labor Complications / Q000453:epidemiology*; D010298:Parity; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011446:Prospective Studies; D012016:Reference Values; D012017:Referral and Consultation / Q000706:statistics & numerical data; D018570:Risk Assessment