Pregnancy Outcome among Elderly Primigravidae: A Five-year Review at Abakaliki, Ebonyi State, Nigeria

Abstract

Introduction: Maternal age is an important determinant of pregnancy outcome and women aged 35 years or more at their first pregnancy are considered high risk pregnancy due to increased risk of feto-maternal morbidity and mortality. Aim: To evaluate the outcome of pregnancy in primigravid women who were aged 35 years and above. Materials and Methods: A five-year retrospective study among elderly primigravidae was conducted. The study assessed 78 booked primigravidae aged 35 years or more who delivered at the Federal Teaching Hospital Abakaliki from 1st January 2012 to 31st December 2016. Each elderly primigravida was matched with two primigravid women aged 20-25 years who delivered during the same period. Postnatal visit was also assessed. Results: During the study period, there were 11,329 deliveries and 78 of these were elderly primigravidae giving an incidence of 0.69% or 1:145 deliveries. The mean age of the elderly primigravidae was 36.28±1.20 years. The study group had more antepartum complications with anaemia, antepartum haemorrhage, hypertensive disorders of pregnancies, diabetes mellitus and preterm labour (p<0.05). Intrapartum complications such as poor progress of labour and cephalo-pelvic disproportion were also significantly higher. Almost half of the study group were delivered by caesarean section, the commonest indication being maternal request based on prolonged infertility (16.67%). The study group had higher incidence of preterm delivery and perinatal mortality of significant proportion. However, they were more likely to come for the 6th week postnatal visit 71.2% versus 32.1%. Conclusion: The problems of elderly primigravidae are still germane and relevant in present day obstetrics. Efforts should be intensified towards identifying this high-risk group with a view to take proactive measures aimed at minimising pregnancy related complications so as to achieve the best outcome for them and their babies.

Keywords

• advanced maternal age
• maternal morbidity
• parturient
• perinatal complications
• reproductive outcome