Pregnancy outcome at advanced maternal age in a group of African women in two teaching Hospitals in Yaounde, Cameroon

Abstract

INTRODUCTION: Women older than 40 years have been termed ,advanced maternal age and considered to be at risk of adverse pregnancy outcome. This study aimed to examine the obstetrical outcomes among primiparous and multiparous African advanced maternal age women. METHODS: We conducted a retrospective case-control study at two teaching hospitals at Yaounde, Cameroon. From the hospital records, obstetrical characteristics of 585 consecutive women aged 40 or above who delivered from January 2007 to December 2011 were compared with those of 1816 younger mothers aged 20 to 29 years as control cases. Associations between maternal age and selected obstetrical variables were assessed with the contigency X2 test or two-tailed Fisher exact test. RESULTS: Primiparous and multiparous advanced maternal age were more likely to undergo cesarean delivery than were their younger counterparts (38.5% vs 13.5%, RR=2.85, p less than 0.05 and 16.1% vs 9.1%, RR=1.76, p less than 0.05). Older primiparous women had similar perinatal outcomes than their younger counterparts. Older multiparous women had increased incidence of preeclampsia/eclampsia (2.4% vs 0.6%, RR=4, pless than 0.01); antepartum hemorrhage (1.8% vs 0.8%, RR=2.25, p less than 0.01); fetal distress (3.5% vs 1.3%, RR=2.69, pless than 0.01); fetal death (3.5% vs 1.6%, RR= 2.18, p less than 0.05); postpartum hemorrhage (2.4% vs 1.2%; RR=2, p less than 0.05); preterm delivery (12% vs 9.2%, RR=1.30, p less than 0.05); low birth weight (11% vs 7.7%, RR=1.42, pless than 0.05); admission to special care neonatalogy unit(14.1% vs 10.2%, RR=1.38, p less than 0.05 ); low Apgar scores at 1min and 5min; and perinatal mortality (3.5% vs 1.6, RR=2.18, pless than 0.05). CONCLUSION: Advanced maternal age women are at higher risk to cesarean delivery. Increased risk of antepartum and intra partum complications among multiparous advanced maternal age women were associated to adverse perinatal outcome. Our results are in concordance with the view that increased risk of adverse perinatal outcome with advanced maternal age is indirectly related to age through the increased risk of obstetrical complications associated with age.

Keywords

• advanced maternal age
• pregancy outcome
• perinatal outcome