Giri A, Srivastav V R, Suwal A, Tuladhar A S
Nepal Med Coll J. 2013 Jun;15(2):87-90.
Advanced maternal age defined as age 35 years or more at estimated date of delivery is considered to have higher incidence of obstetric complications and adverse pregnancy outcome than younger women. The objective of this study was to compare the obstetric and perinatal outcome of pregnancies in women with advanced maternal age > or = 35 years with that of younger women < 35 years. A prospective comparative study was carried out in department of obstetrics and gynecology at Nepal Medical College and Teaching Hospital over the period of one year from October 2012 to September 2013. The obstetric and perinatal outcome of 90 women with advanced maternal age (study group) were compared with those of 90 younger women aged 20-34 years (control group). Among antenatal complications, women of advanced maternal age had increased incidence of hypertensive disorder of pregnancy (26.6% vs 4.4%; p = 0.00009) and breech presentation (8.8% vs 1.1%; p = 0.04). There were no significant difference between two groups in incidence of antepartum hemorrhage, gestational diabetes mellitus, prelabor rupture of membrane and preterm delivery. The rate of caesarean delivery was significantly higher in advanced maternal age (28.8% vs 17.7%; p = 0.05). In perinatal outcome, older women had significantly higher incidence of perinatal death (7.7% vs 0%; p = 0.01). There were no significant differences in low birth weight rate and apgar score less than 7 at five minutes of life in two groups. Thus from this study, it can be concluded that advanced age women had higher incidence of hypertensive disorder of pregnancies and malpresentation, were more likely to deliver by caesarean section and had increased incidence of perinatal death.
将分娩预估日期时年龄35岁及以上定义为高龄产妇，与年轻女性相比，其产科并发症和不良妊娠结局的发生率更高。本研究的目的是比较年龄≥35岁的高龄产妇与年龄<35岁的年轻女性的产科和围产期结局。2012年10月至2013年9月期间，在尼泊尔医学院及教学医院妇产科进行了一项前瞻性对照研究。将90名高龄产妇（研究组）的产科和围产期结局与90名年龄在20 - 34岁的年轻女性（对照组）进行比较。在产前并发症方面，高龄产妇妊娠高血压疾病的发生率增加（26.6%对4.4%；p = 0.00009）以及臀位（8.8%对1.1%；p = 0.04）。两组在产前出血、妊娠期糖尿病、胎膜早破和早产的发生率上无显著差异。高龄产妇剖宫产率显著更高（28.8%对17.7%；p = 0..05）。在围产期结局方面，年龄较大的女性围产期死亡发生率显著更高（7.7%对0%；p = 0.01）。两组在低出生体重率和出生后5分钟阿氏评分低于7分方面无显著差异。因此，从本研究可以得出结论，高龄女性妊娠高血压疾病和胎位异常的发生率更高，更有可能通过剖宫产分娩，且围产期死亡发生率增加。
