[Impact of maternal age on perinatal outcomes and mode of delivery].
OBJECTIVE
to analyze the association of the mother's age, the perinatal outcome and the delivery route.


METHODS
information about all the patients attended at the Service of Obstetrics and Gynecology of a tertiary university hospital in Maranhão, from July to December 2006, was analyzed. Patients have been allocated in three groups: adolescents (10 to 19 years old), adults (20 to 34 years old), and aged women (>35 years old). Variables studied were: skin color, schooling, marital status, family income, parity, number of appointments during pre-natal care, gestational age at the onset of pre-natal care, delivery route, Apgar index at the fifth minute and birth weight. Data were processed by the Epi-info program, version 3.4.1, and the association among the variables was analyzed by the Odds Ratio (OR) or the cross product ratio, with confidence intervals (CI) of 95%. The significance level was 0.05.


RESULTS
among 2,196 patients, 25% of deliveries occurred in adolescents, 69% in adults and 6% in aged women. Among the adolescents, there was higher risk of prematurity (OR=1.46; CI 95%=1.14-1.88), and low birth weight (OR=1.47; CI 95%=1.13- 1.90), higher incidence of normal delivery as compared to the other groups (65.2%), besides the association with late onset of pre-natal care (OR=1.86; CI 95%=1.43-2.43), lower number of appointments (OR=2.03; CI 95%=1.57-2.63), and use of abortive procedures at the onset of gestation (OR=2.34; CI 95%=1.38-3.98). Among aged women, there was strong association with diabetes mellitus (OR=9.00; CI 95%=3.18-25.19), pre-eclampsia (OR=4.38; CI 95%=3.02-6.34), premature membrane rupture (OR=5.81; CI 95%=3.08-10.89), besides a higher chance of presenting Apgar index lower than seven at the fifth minute (OR=2.90; CI 95%=1.37-6.01), and higher ratio of cesarean section (60.3%).


CONCLUSIONS
pregnancy in adolescence is associated to late onset of pre-natal care and few appointments along it, use of abortive procedures at the onset of gestation, low schooling, no mates, low birth weight, prematurity, and lower incidence of cephalo pelvic disproportion and pre-eclampsia. Among aged pregnant women, there was association with diabetes, pre-eclampsia, premature membrane rupture, Apgar index lower than seven at the fifth minute and higher ratio of cesarean section.
Serviço de Obstetrícia e Ginecologia, Hospital Universitário, Universidade Federal do Maranhão, São Luís, MA, Brasil. gracietehelenans@yahoo.com.br
Graciete Helena Nascimento Dos
GH
Santos
Marília da Glória
Mda G
Martins
Márcia da Silva
Mda S
Sousa
Sandro de Jesus Costa
Sde J
Batalha
D000293:Adolescent; D000328:Adult; D002648:Child; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D006801:Humans; D008423:Maternal Age; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D055815:Young Adult