First pregnancy in women after age 35

Abstract

Objectives: To determine the frequency and risk of complications in women 35 years or older with first pregnancy. Design: Analytical study of cases and controls. Setting: Huacho Regional Hospital and Universidad Nacional Jose Faustino Sanchez Carrion, Huacho, Peru. Participants: Women 35 years or older and 20 to 34 year-old with first pregnancies. Interventions: Review of the Perinatal Information System and related medical records from 2002 through 2006 of 72 women 35 years or older (cases) and 20 to 34 yearold (controls) carrying their first pregnancies. Population reference was 13 384 deliveries in those years. Frequency of complications, odds ratio and corresponding confidence intervals and chi square non parametric tests were determined. Main outcome measures: Frequency of complications. Results: Older primigravidae had more pregnancy-induced hypertension (OR=2.67, p=0.033), first trimester bleeding (OR=6.99, p=0.004), multiple pregnancy (OR=7.5, p<0.001) and cesarean delivery (OR=6.46, p<0.001). Primigravidae newborns presented more low birth weight (OR=2.07, p=0.033), hyperbilirubinemia (OR=2.3, p=0.026) and neurological disease (OR=9.78, p<0.001). Conclusions: Pregnancy-induced hypertension, first trimester bleeding, multiple pregnancy, cesarean delivery, and low birth weight, hyperbilirubinemia and neurological disease in newborns were more
common in primigravidae 35 or older but none of such seriousness to discourage late motherhood.