Pregnancy outcome in a Spanish population of women beyond age 40 delivered above 32 weeks’ gestation

Abstract

Objective: To investigate the effect of age and parity on obstetric outcome in a Spanish population of pregnants aged 40 years or older delivered above 32 weeks’gestation. Methods: A retrospective cohort of 16764 singleton pregnancies delivered above 32 weeks’gestation between 2000 and 2007 in a nontertiary community hospital was studied. Obstetric outcomes in women aged 40 years or above (n = 335) were compared to women aged 20–29 years (n = 347) delivered at the same period. Results: During the study period, the prevalence of mothers aged 40 or above increased from 1.6% to 3%. Older pregnants were more likely to be multiparous and to have used assisted reproductive techniques. They were more likely to develop gestational diabetes (OR 7.77, 3.50–17.94) and preeclampsia (OR 2.60, 1.13–6.16) and to have a higher rate of cesarean delivery (OR 2.95, 1.98–4.42). Elective was the most frequent cause of cesarean delivery in this group. Newborns were at higher risk to suffer diabetes-related complications but no differences neither in 5-min Apgar score of <7 nor in the need for admission into special care baby unit were found. No perinatal deaths were registered. Conclusion: Our Spanish population of older mothers showed a higher risk for being delivered by cesarean section and for developing either preeclampsia or gestational diabetes. The overall neonatal outcome was unaffected. These data may be helpfull to counsel patients about their pregnancy expectations and possible outcomes.

Keywords::

• Advanced maternal age
• diabetes
• high risk pregnancy
• perinatal outcome
• preeclampsia

Declaration of interest: The authors declare that there is no conflict of interest.