title: Elderly primigravidae versus young primigravidae: a review of pregnancy outcome in a low resource setting.
abstract: BACKGROUND
  The elderly primigravida is defined as a woman who goes into pregnancy for the first time at the age of 35 years or older. Progressively, this has become more common in our contemporary society and traditionally such pregnancy is regarded as high risk.
  
  
  OBJECTIVE
  This was to determine and compare the pregnancy outcomes in elderly primigravidae aged 35 years and above with those of young primigravidae aged 20-25 years
  
  
  METHODS
  The pregnancy outcomes of 82 elderly primigravidae (study group) with a singleton gestation, who delivered in the Teaching Hospital from 1st July, 2005 to 30th June, 2010 were compared with those of 131 young primigravidae (control group) who delivered during the same period in the same hospital.
  
  
  RESULTS
  During the study period, there were 3,189 deliveries, given an incidence of elderly primigravidity as 2.6% or 1 in 39 deliveries. The mean age of the study group and control group were 36.4 +/- 0.9 years and 23.1 +/- 1.6 years respectively. The incidence of anaemia, antepartum haemorrhage, hyperemesis gravidarum, malpresentation, intrauterine growth restriction, diabetes mellitus and fibroid were statistically higher in the elderly primigravidae than in the control (p < 0.05). Cephalopelvic disproportion, prolonged second stage, fetal distress and primary post partum haemorrhage were also statistically higher (p < 0.05) including the caesarean section (53.7%) and episiotomy rates (94.6%).
  
  
  CONCLUSIONS
  Elderly primigravida remains a high risk pregnancy and the incidence is high. They were significantly associated with adverse pregnancy outcomes and operative obstetric interventions. Early booking and more obstetric vigilance shall improve their pregnancy outcomes.
authors.forename: George Uchenna
authors.initials: GU
authors.lastname: Eleje
authors.forename: Anthony Osita
authors.initials: AO
authors.lastname: lgwegbe
authors.forename: John E N
authors.initials: JE
authors.lastname: Okonkwo
authors.forename: Gerald O
authors.initials: GO
authors.lastname: Udigwe
authors.forename: Ahizechukwu Chigoziem
authors.initials: AC
authors.lastname: Eke
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008423:Maternal Age; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D010298:Parity; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome; D018566:Pregnancy, High-Risk; D012189:Retrospective Studies; D055815:Young Adult