Introduction: It is very evident that pregnancies at advanced maternal age (AMA) is increasing internationally, due to multifactorial social socio-cultural and economic development. These pregnancies are associated with significant adverse pregnancy outcomes.
Patients & Methods: The study was conducted as an ambispective cohort study at a tertiary care Medical College Hospital over a period of 4and a half years from December 2013 to May 2018 to evaluate the outcomes associated with the risk.
Results: Patients from higher socio-economic class, better education and more food availability appeared to have pregnancies at AMA. Such pregnancies place the patients at significant risk for development of hypertension (aRR – 1.53, 95%CI (1.22 – 1.60), P < 0.001) and diabetes (aRR – 1.23, 95%CI (1.36 – 1.94), P<0.001). The risk of antepartum haemorrhage and malpresentation also increases but premature rupture of membranes and preterm don’t appear to be clearly associated. Older mothers are more likely to undergo a cesarean section with an aRR of 1.54 (95%CI, 1.15 – 1.28); P < 0.001 and less likely to have a vaginal delivery (aRR – 0.61; 95%CI, 0.51-0.69). Those having a vaginal birth are at higher risk of instrumental interference with an aRR of 1.47 (95%CI, 1.27-1.77). Post partum haemorrhage doesn’t appear to significantly vary with a P value of 0.25. Intrapartum foetal distress also appears to be significantly higher (P-0.005) in older mothers (aRR – 1.43; 95%CI, 1.22-1.59).
Conclusions: AMA is associated with adverse maternal and fetal outcomes hence should be investigated to provide evidence based options to the patient which will aid in decision making.