Child-bearing beyond age 50: pregnancy outcome in 59 cases "a concern?".
OBJECTIVE
To study maternal and perinatal outcomes in healthy women aged 50 years and older.


METHODS
This study was of 59 clinical pregnancies, of which 10 ended in first trimester spontaneous miscarriage (and were excluded from further studies) and 58 live births. This retrospective review of 58 live births in 49 essentially healthy women (mean [SE] age, [52+/-2.5] years; range 50-55 years), with no chronic medical conditions (of which 28 were primigravids). Pregnancy outcomes were ascertained by chart review and telephone follow-up.


RESULTS
Of the 58 live births, 41 were singletons, and 7 were twins, and 1 triplet, for which the mean+/-SE gestational age at delivery were 38.1 weeks +/-0.4, 36.2 weeks +/-0.1 and 34.1 weeks respectively. Birth weights (mean +/- SE) were 3,201 g+/-10, 2,252 g+/-4 and 1,998+/-95 g respectively. Mean Apgar score +/- SE at 1 and 5 min were 9.2+/-0.8 and 8.8+/-0.6 respectively. Total cesarean deliveries were 73% (36/49). Of singletons 68% (28) were delivered by cesarean section as were all multiples. The incidence of pre-eclampsia was 30.6%: mild pre-eclampsia 20.4% (10/49), severe pre-eclampsia 10.2% (5/49). Gestational diabetes required insulin in all 19.5% of women. Anemia was noted in 6.5%.


CONCLUSIONS
Appropriately screened women, aged 50 years or older, can deliver successfully. During pregnancy, they appear to be at increased risk of pre-eclampsia and gestational diabetes. A significant majority can expect to deliver via cesarean.
Chibber
Rachana
R
Department of Obstetrics and Gynecology, King Fahd Hospital of the University College of Medicine, King Faisal University, PO Box 2208, 31952 Al-Khobar, Saudi Arabia. rchibber57@hotmail.com
D000328:Adult; D001034:Apgar Score; D001724:Birth Weight; D016022:Case-Control Studies; D002585:Cesarean Section / Q000706:statistics & numerical data; D015331:Cohort Studies; D016640:Diabetes, Gestational / Q000188:drug therapy / Q000453:epidemiology; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D015994:Incidence; D007328:Insulin / Q000627:therapeutic use; D007407:Interviews as Topic; D008423:Maternal Age; D008875:Middle Aged; D011225:Pre-Eclampsia / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D011272:Pregnancy, Multiple; D012189:Retrospective Studies; D012307:Risk Factors; D012529:Saudi Arabia / Q000453:epidemiology; D014310:Triplets; D014427:Twins
D007004:Hypoglycemic Agents; D007328:Insulin