Background: Delayed childbearing has resulted in an increasing number of women conceiving for the first time at advanced maternal age. Pregnancies in elderly primigravida are associated with higher rates of medical complications, increased operative delivery, and adverse neonatal outcomes due to age-related physiological changes and the growing use of assisted reproductive techniques.¹–³
Methods: This retrospective observational study was conducted over a one-year period at Amrita Institute of Medical Sciences, Kochi, a tertiary care teaching hospital. During the study period, 1182 deliveries occurred, of which 50 women were elderly primigravida (?35 years), giving an incidence of 4.23%. Maternal demographic characteristics, socioeconomic status, educational status, medical comorbidities, mode of conception, obstetric outcomes, intraoperative and postoperative complications, and neonatal outcomes were analysed. Twins were considered as separate neonates. Data were expressed as frequencies and percentages.
Results: The majority of women were aged 35–39 years (60%), while 40% were aged ?40 years. According to the Modified Kuppuswamy classification, 56% belonged to the upper middle and 44% to the lower middle socioeconomic class. Gestational diabetes mellitus was the most common maternal complication (40%). Followed by Hypertensive disorders of pregnancy: 30%, Overt diabetes mellitus: 20% and Hypothyroidism: 18%. Assisted reproductive techniques accounted for 56% of conceptions. Caesarean section was the predominant mode of delivery (82%). Intraoperative complications were infrequent; postpartum haemorrhage occurred in one patient (2%), and postoperative urinary retention was noted in one patient (2%), both managed conservatively. A total of 56 neonates were delivered, including six twin gestations. Adverse neonatal outcomes were observed in 30 neonates (53.6%), NICU admission was required in 24 neonates (42.9%), and neonatal mortality occurred in two cases (3.6%).The observed neonatal morbidity profile reflects the tertiary referral nature nature of the study centre with advanced neonatal intensive care and paediatric cardiology services.
International Journal of Clinical Obstetrics and Gynaecology
Indexed in Index Copernicus
Research Journals