[Particularities of pregnancy and labor in 40-year-old women. Report of 300 cases].
BACKGROUND
Pregnancy beyond age 40 is considered as a high risk pregnancy associated with high rates of maternal and fetal complications.


OBJECTIVE
To analyze particularities of pregnancy and labor and to examine obstetrical and neonatal outcomes among women age 40 years and older.


METHODS
There was a retrospective study including two groups of 300 patients, the first including the 40-year- old and over women (case group), and the second including 20-to 39 -year-old mothers (control group).


RESULTS
The mean age for the case group was 41 years. Ten (10.6%) of the women in the ca se group were primiparous as compared with twenty-seven (27.5%) in the control one (p=0.001).The antenatal surveillance was better in the control group. The morphologic sonograhy was performed in 73% of cases of 40-year -old-women versus 90% in the control group (p<0.001). Maternal age 40 and over was associated with an increased risk for gestational diabetes (6.4% versus 1.7%, p<0.001). The premature rupture of membranes was frequent in the case group (25.7% versus 11.7% p<0.001), and the amniotic fluid meconuim (16.3% versus 6.7%, p<0.001). The risk for cesarean section was higher in older women (25.7% versus 14% avec p <0.001). Neonatal outcomes (Apgar score, birth weight, perinatal mortality) were similar to those in the younger age group.


CONCLUSIONS
The analysis of our results and the review of the literature have proven that advanced-maternal-age-pregnancy is associated with increased complications. So some recommendations' are necessary to ameliorate the management of this pregnancy.
Service de Gynécologie Obstétrique et de Médecine de la reproduction de l'Hôpital Aziza.
Asma
A
Jnifen
Anis
A
Fadhlaoui
Anis
A
Chaker
Fethi
F
Zhioua
D000328:Adult; D016022:Case-Control Studies; D002585:Cesarean Section / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008423:Maternal Age; D008470:Meconium; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D014416:Tunisia / Q000453:epidemiology