title: [Pregnancy beyond age 40 in 382 women: a retrospective study in Reunion Island].
abstract: OBJECTIVE
  To examine obstetrical and neonatal outcomes among women age 40 years and older.
  
  
  METHODS
  There was a retrospective study including 382 pregnant women at least 40 years of age and 7786 controls aged 20-34, stratified according to parity. Associations between maternal age and pregnancy outcomes were assessed using Pearson's chi(2) test, Fischer exact test, Student test or Mann and Whitney test, as appropriate.
  
  
  RESULTS
  Maternal age 40 and over was associated with an increased risk for gestational diabetes (multiparas: OR 3.2, 95%CI 2.2-4.8; grandmultiparas: 2.8, 1.6-5.0), chronic diabetes (multiparas: 3.5, 1.04-10.6), chronic hypertension (multiparas: 3.1, 1.5-6.1; grandmultiparas: 12.1, 3.3-53.2), pregnancy-induced hypertension (nulliparas: 4.6, 1.01-17.3; multiparas: 2.6, 1.3-5.4) and preclampsia (multiparas: 2.9, 1.1-7.2). The risk for cesarean section was 2-fold higher in older multiparas and grandmultiparas. The same was true for the rate of operative vaginal delivery. The rate of fetal chromosomal abnormalities was 7-fold higher in older gravidas. Rates of fetal death were significantly increased in the cohort of older pregnant women (nulliparas: 11.2, 2.9-44.0; multiparas: 3.9, 1.4-10.9).
  
  
  CONCLUSIONS
  Pregnancy at age 40 and over is associated with high rates of obstetrical complications, cesarean sections and operative vaginal deliveries, emphasizing the importance of rigorous antenatal care.
authors.affiliation: Service de Gynécologie et Obstétrique, Groupe Hospitalier Sud Réunion, 97448 Saint Pierre, Ile de la Réunion, France. horace.roman@libertysurf.fr
authors.forename: H
authors.initials: H
authors.lastname: Roman
authors.forename: P-Y
authors.initials: PY
authors.lastname: Robillard
authors.forename: C
authors.initials: C
authors.lastname: Julien
authors.forename: E
authors.initials: E
authors.lastname: Kauffmann
authors.forename: A
authors.initials: A
authors.lastname: Laffitte
authors.forename: M
authors.initials: M
authors.lastname: Gabriele
authors.forename: L
authors.initials: L
authors.lastname: Marpeau
authors.forename: G
authors.initials: G
authors.lastname: Barau
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002585:Cesarean Section; D016001:Confidence Intervals; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D005313:Fetal Death; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D008423:Maternal Age; D008875:Middle Aged; D007744:Obstetric Labor Complications / Q000453:epidemiology*; D016017:Odds Ratio; D010298:Parity; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome; D018566:Pregnancy, High-Risk; D012189:Retrospective Studies; D017508:Reunion / Q000453:epidemiology; D012307:Risk Factors