Simten Genc, Obstetrics and Gynecology Department, Okmeydani Training and Research Hospital, Istanbul 34384, Turkey,
Croat Med J. 2021 Apr 30;62(2):130-136. doi: 10.3325/cmj.2021.62.130.
To examine the characteristics of pregnancies at a very advanced maternal age and the effect of parity on adverse obstetric outcomes.
We retrospectively reviewed the records of women who gave birth at the Obstetrics and Gynecology Department of Okmeydanı Training and Research Hospital between January 2012 and December 2019. Overall, 22 448 of women were younger than 40 and 593 were aged 40 and older. Women aged 40 and older were divided into the primiparous (52 or 8.77%) and multiparous group (541 or 91.23%).
Significantly more women aged 40 and older had a cesarean section. The most common indications for a secondary cesarean delivery in both age groups were a previous cesarean procedure or uterine operation. The most frequent indication for primary cesarean section in both groups was fetal distress. Cesarean section rates due to non-progressive labor, fetal distress, and preeclampsia were significantly more frequent in primiparous women compared with multiparous women aged 40 and older. In primiparous women, fetal birth weight was lower and preeclampsia/gestational hypertension frequency were higher.
Since primiparity was a risk factor for lower fetal birth weight and preeclampsia/gestational hypertension in the age group of 40 years and above, more attention should be paid to the follow-up and treatment of these patients.
探讨极高龄产妇妊娠的特点及初产妇与经产妇对不良产科结局的影响。
我们回顾性分析了 2012 年 1 月至 2019 年 12 月在 Okmeydanı培训和研究医院妇产科分娩的妇女的记录。共有 22448 名年龄小于 40 岁的妇女和 593 名年龄 40 岁及以上的妇女。年龄在 40 岁及以上的妇女分为初产妇(52 例,8.77%)和经产妇组(541 例,91.23%)。
年龄在 40 岁及以上的妇女剖宫产率显著升高。两组剖宫产的主要指征均为既往剖宫产史或子宫手术史。两组中初产妇行剖宫产的主要指征均为胎儿窘迫。初产妇因产程无进展、胎儿窘迫和子痫前期行剖宫产的比例明显高于经产妇。初产妇的胎儿出生体重较低,子痫前期/妊娠期高血压的发生率较高。
由于初产是年龄在 40 岁及以上的产妇胎儿出生体重低和子痫前期/妊娠期高血压的危险因素,因此应更加关注这些患者的随访和治疗。