Advanced maternal age and late pregnancy outcome at Omdurman New Hospital in Sudan

  • Authors

    • Khalid Ahmed University of Al Neelain
    • Shireen Ahmed Omdurman New Hospital
    • Siddig Handady Imperial Hospital
    • Awad Alawad University of Medical Sciences and Technology
    • Sulafa Ali
    2015-10-23
    https://doi.org/10.14419/ijm.v3i2.5357
  • Advance Maternal Age, Fetal Outcome.
  • Abstract

    Background: Advanced Maternal age has a 2–3 fold higher risk of pregnancy-related death than women in their twenties, and the risk is even more dramatic for women 40 years and older.

    Objective: The overall aim was to examine the association between maternal age and a wide range of adverse pregnancy outcomes.

    Methodology: This is a case-control hospital-based study carried out at Omdurman New Hospital in Khartoum State, Sudan in the period from July 2013 to January 2014. Three hundred women presented in labour were enrolled in this study. One hundred women at 40 years age or more presented after 24th week of pregnancy represented the study group. Two hundred women between 18-39-year age; same gestational ages were selected as the control group.

    Results: The mean of age was 42±2 STD (min 40 and max 45 years) among the case group, and it was 27±2 STD (min 20 and max 39 years) among the case group. Women aged 40 years or older had increased percentages of gestational hypertension (23.0% vs. 13.5%; p=0.03) and diabetes in pregnancy (8.0% vs. 4.0%; p=0.03) compared with women younger than 40 years. There were significant differences between the two age groups in, antepartum hemorrhage, preterm labor, and premature rupture of membranes, perinatal death, and postpartum hemorrhage. Vaginal delivery in case group was 53 (53%) against 127 (63.5%) in control group, caesarean section found in 47 (47%) of case group against 36.5% of control group, instrumental found in one patient (1%) of case group and it was absent in control group.

    Conclusion: Advanced maternal age is a risk factor for premature rupture of membranes, preterm labour, pre-eclampsia, stillbirth, gestational diabetes mellitus, placenta previa, abruptio placentae and cesarean section, but not for small for gestational age, gestational hypertension, or large for gestational age.

  • References

    1. [1] Balasch J & Gratacos E (2012): Delayed childbearing: effects on fertility and the outcome of pregnancy. Curr Opin Obstet Gynecol 24, 187-193.http://dx.doi.org/10.1097/GCO.0b013e3283517908.

      [2] Bayrampour H, Heaman M, Duncan KA & Tough S (2012): Advanced maternal age and risk perception: a qualitative study. BMC Pregnancy Childbirth 12, 100.http://dx.doi.org/10.1186/1471-2393-12-100.

      [3] Chan BC & Lao TT (2008): Effect of parity and advanced maternal age on obstetric outcome. Int J Gynaecol Obstet 102, 237-241.http://dx.doi.org/10.1016/j.ijgo.2008.05.004.

      [4] Cleary-Goldman J, Malone FD, Vidaver J, Ball RH, Nyberg DA, Comstock CH, Saade GR, Eddleman KA, Klugman S, Dugoff L, Timor-Tritsch IE, Craigo SD, Carr SR, Wolfe HM, Bianchi DW, D'Alton M & Consortium F (2005): Impact of maternal age on obstetric outcome. Obstet Gynecol 105, 983-990.http://dx.doi.org/10.1097/01.AOG.0000158118.75532.51.

      [5] Franz MB & Husslein PW (2010): Obstetrical management of the older gravida. Womens Health (Lond Engl) 6, 463-468.http://dx.doi.org/10.2217/whe.10.26.

      [6] Gilbert WM, Nesbitt TS & Danielsen B (1999): Childbearing beyond age 40: pregnancy outcome in 24,032 cases. Obstet Gynecol 93, 9-14.http://dx.doi.org/10.1016/S0029-7844(98)00382-2.

      [7] Giri A, Srivastav VR, Suwal A & Tuladhar AS (2013): Advanced maternal age and obstetric outcome. Nepal Med Coll J 15, 87-90.

      [8] Gribble KE, Jarvis G, Bock M & Mark Welch DB (2014): Maternal caloric restriction partially rescues the deleterious effects of advanced maternal age on offspring. Aging Cell 13, 623-630.http://dx.doi.org/10.1111/acel.12217.

      [9] Luke B & Brown MB (2007): Contemporary risks of maternal morbidity and adverse outcomes with increasing maternal age and plurality. Fertil Steril 88, 283-293.http://dx.doi.org/10.1016/j.fertnstert.2006.11.008.

      [10] Steiner AZ & Paulson RJ (2007): Motherhood after age 50: an evaluation of parenting stress and physical functioning. Fertil Steril 87, 1327-1332.http://dx.doi.org/10.1016/j.fertnstert.2006.11.074.

      [11] Suzuki S & Miyake H (2008): Obstetric outcomes in nulliparous women aged 35 and over with singleton pregnancies conceived by in vitro fertilization. Arch Gynecol Obstet 277, 225-227.http://dx.doi.org/10.1007/s00404-007-0461-y.

      [12] Tandberg A, Klungsoyr K, Romundstad LB & Skjaerven R (2015): Pre-eclampsia and assisted reproductive technologies: consequences of advanced maternal age, interbirth intervals, new partner and smoking habits. BJOG 122, 915-922.http://dx.doi.org/10.1111/1471-0528.13051.

      [13] Usta IM & Nassar AH (2008): Advanced maternal age. Part I: obstetric complications. Am J Perinatol 25, 521-534.http://dx.doi.org/10.1055/s-0028-1085620.

      [14] Ziadeh SM (2002): Maternal and perinatal outcome in nulliparous women aged 35 and older. GynecolObstet Invest 54, 6-10.http://dx.doi.org/10.1159/000064689.

  • Downloads

  • How to Cite

    Ahmed, K., Ahmed, S., Handady, S., Alawad, A., & Ali, S. (2015). Advanced maternal age and late pregnancy outcome at Omdurman New Hospital in Sudan. International Journal of Medicine, 3(2), 115-117. https://doi.org/10.14419/ijm.v3i2.5357

    Received date: 2015-09-23

    Accepted date: 2015-10-18

    Published date: 2015-10-23