MATERNAL AND PERINATAL OUTCOME IN ADVANCED MATERNAL AGE: A HOSPITAL BASED PROSPECTIVE STUDY

BACKGROUND The term 'elderly parturient' was defined in 1958 by the Council of International Federation of Obstetrics as one aged 35 years or more at the first delivery. Rising trend of pregnancy in advanced maternal age has raised serious concerns amongst health providers because pregnancy in older age is considered to be more hazardous both from material and foetal prospective. The aim of this study was to evaluate pre-existing medical disorders, antenatal complication, mode of delivery and perinatal outcome in advanced maternal age. MATERIAL AND METHODS This hospital based prospective study was conducted in SMGS Hospital, Jammu. It included 140 patients each in 2 groups with study group comprising of women with age ? 35 years and control group comprising of women between 20-29 years of age. All the women who were fit in inclusion criteria underwent detailed history and examination and investigation. The study and control groups were compared according to the objectives. RESULTS Parity was significantly higher in the study group. Among antenatal complications, anaemia and hypertension were significantly higher in study group. There was no statistically significant difference in the incidence of malpresentation, preterm labour, antepartum haemorrhage and multiple pregnancies in the two groups. There was higher incidence of caesarean sections and instrumental deliveries in the study group. Among caesarean sections, rate of elective caesarean sections was significantly higher in the study group. No significant increase in the incidence of postpartum complications was seen in the study group. Patients of advanced maternal age were associated with adverse perinatal outcome in the form of higher incidence of babies with Apgar score<7 at 5 minutes and higher perinatal mortality.