Introduction: In recent decades, the age at childbearing has continued to increase for multiple reasons. These include the education of girls, delayed marriage, pursuit of professional careers, the desire to conceive after a second union, the availability of assisted reproductive technologies, and the low uptake of family planning methods. Consequently, late pregnancies are associated with increased risks for both the mother and the fetus.
Materials and Methods: This was a retrospective analytical case-control study, unmatched, conducted over 11 years from January 1, 2008 to December 31, 2018, in the Department of Gynecology and Obstetrics of CHU Point G, Bamako.
Results: The frequency of childbirth at advanced maternal age (? 40 years) was 1.93 %. Married women were the most represented in both cases and controls. Women aged 40 years and above were 1.7 times more likely to develop hypertension compared with women aged 20-34 years. Diabetes was observed in 12.36 % of cases versus 0.04 % of controls. Placenta previa occurred exclusively in cases (7.18%). The risk of anemia was significantly higher among older parturient (OR = 5.95). No significant association was found between advanced maternal age and cesarean delivery (OR = 1.22), maternal death, or a low Apgar score (0-7 at 1 minute, OR = 1.17). Low birth weight (< 2500 g) was observed in 21.88% of younger mothers (20-34 years) and 23.85% of older mothers (? 40 years).
Conclusion: Pregnancy at 40 years of age and beyond constitutes a high-risk situation for both mother and child. Maternal risks include hypertension, diabetes, placenta previa, anemia, and an increased likelihood of cesarean section. For the newborn, advanced maternal age is associated with a higher risk of stillbirth, prematurity, and macrosomia.
International Journal of Clinical Obstetrics and Gynaecology
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