title: Is pregnancy over 45 with very high parity related with adverse maternal and fetal outcomes?
abstract: OBJECTIVE
  To examine whether very high parity and age over 45 years are related with adverse maternal and fetal outcomes.
  
  
  METHODS
  This study was carried out at the Department of Obstetrics and Gynecology from January 1, 2007 to December 31, 2007. Sixty-one pregnant women were enrolled in this prospective study. Mothers were classified in two groups: the study group (n = 23) included women with very high parity over 45 years of age (age > 45 and > or = 10 previous live births), and a control group (n = 38) included women with high parity between 40-45 years of age (between 40-45 years and 5-9 previous live births). Hypertensive disorders complicating pregnancy, preterm labor, breech presentation, cesarean section ratio, mean APGAR scores, birthweight, fetal sex, fetal macrosomia, and early neonatal death were compared within groups.
  
  
  RESULTS
  Six (26%) patients in the study group and 12 (31.5%) patients in the control group had hypertensive disorders of pregnancies (p > 0.05). Twelve (52.1%) patients in the study group and 22 (57.8%) patients in the control group had preterm labor (p > 0.05). One (4%) patient in the study group and two (5.2%) patients in the control group had breech presentation during delivery (p > 00.5). Twelve (52.1%) patients in the study group and 21 (55.2%) patients in the control group had cesarean operations (p > 0.05). Mean APGAR scores (at 1 min and 5 min), mean birthweight, fetal sex ratio, fetal macrosomia ratio, and early neonatal death ratio due to prematurity were not statistically significant in the study group as compared with the control group.
  
  
  CONCLUSIONS
  It is generally assumed that women with advanced age have an increased risk for complications during pregnancy. However, prospective population-based studies do not exist and available publications give conflicting views. Based on our results, we hypothesized that cases aged 45 or over with very high parity are not always related with adverse maternal and fetal outcomes.
authors.affiliation: Department of Obstetrics and Gynecology, Dicle University School of Medicine, Diyarbakir, Turkey. drakale@dicle.edu.tr
authors.forename: A
authors.initials: A
authors.lastname: Kale
authors.forename: U
authors.initials: U
authors.lastname: Kuyumcuoğlu
authors.forename: A
authors.initials: A
authors.lastname: Güzel
mesh_terms: D000328:Adult; D001034:Apgar Score; D016022:Case-Control Studies; D005260:Female; D005315:Fetal Diseases / Q000453:epidemiology; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology; D015994:Incidence; D007231:Infant, Newborn; D008297:Male; D008423:Maternal Age; D008875:Middle Aged; D007744:Obstetric Labor Complications / Q000453:epidemiology; D010298:Parity; D054238:Perinatal Mortality; D011247:Pregnancy; D011256:Pregnancy Outcome; D014421:Turkey / Q000453:epidemiology