Because delayed childbearing is increasing nowadays, it is important to understand the implications of advanced maternal age for both mother and baby.
The definition of advanced maternal age in the obstetric literature is variable. But more recently the definition set by the Council of the International Federation of Obstetrics in 1958 stated ' an elderly primigravida is one 35 years or more at
the
first delivery'.
Regardless of the specific age definition, the effects of increasing maternal age on pregnancy outcome remain unresolved issue. Generally pregnancies in women of advanced maternal age are considered by many to be high risk. But there were many
reports
that pregnancy in advanced maternal age was quite safe, especially in the absence of preexisting medical disorders. What should be emphasized is the fact that few pregnancy related problems in elderly primipara are readily manageable. Given sound
genetic diagnosis and counseling, together with appropriate prenatal care and the judicious management of labor and delivery, the increasing number of women postponing first pregnancies can look forward to excellent outcomes.
We conducted this study to analyze maternal and perinatal outcomes in elderly primipara and to get informations for the care of the elderly primipara women.
The study was based on 119 cases(17 cases out of 119 were excluded because of insufficient clinical records) of elderly primipara who received antenatal care and gave a birth in obstetric ward of Pusan Paik hospital from January 1, 1985 to
December
31,
1994.
@ES The results were as follows:
@EN 1. There were 119 cases of elderly primipara among 14574 deliveries, the incidence of elderly primipara was 0.82%, Maternal age was from 35 to 42 years. The majorities (57.8%) were in the age group of 35 and 36 years. The overall incidence of
infertility and chronic illness(hypertension, diabetes mellitus, hyperthyroidism) was 31.3%.
2. About 1/4(26.4%) had maternal morbidities and complications(pregnancy induced hypertension : 12.7%, abnormal uterine bleeding due to placenta previa or abruptio placenta : 4.9%, admission in obstetric department due to pregnancy related
complications : 8.8%). The incidence of breech presentation was 8.8%. The incidence of cesarean section was 36.3% and the main indication of cesarean section was elderly primipara(37.8%).
3. The incidence of past spontaneous abortion was 24.5%. The perinatal mortality rate and congenital anomaly was 108 and 2.9%, respectively. The incidence of premature delivery and postterm delivery was 15.7% and 4.9%, respectively. The
incidence
of
low birth weight infant and macrosomia weighing more than 4000 gm was 25.5% and 4.7%, respectively. The incidence of APGAR score less than 6 was 20.8% in 1 minute, and 9.5% in 5 minutes. The admission at NICU was 17.2% and the main cause of
admission
was prematurity.
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