Pregnancy and delivery in primigravidae aged 35 and over.

A retrospective study was performed on 111 consecutive primigravidae aged 35 and above (study group) who delivered in the Gynaecological Oncology Department, Kandang Kerbau Hospital, Singapore during the two-year period (1990 and 1991). For comparison, all the 10,189 patients in the department who were delivered during the same time period were also analysed and served as the control group. The aim of the study was to examine the risks involved with advanced maternal age, the obstetric performance and neonatal outcome of both groups in the context of modern obstetric care in Singapore. In the study group, pre-eclampsia was the commonest antenatal complication (17.1%), followed by preterm labour (16.2%) and diabetes mellitus (including impaired glucose tolerance test) (16.2%). In the control group, the corresponding incidences were 10.8%, 6.3% and 2.8% respectively. The incidence of labour induction (28.8%) and instrumental deliveries (31.5%) were higher in the study group than in the control group (7.1% and 7.3% respectively). The Caesarean section rate was twice as common in the study group (32.4%) than in the control group (16%). Only 15 patients (13.5%) had amniocentesis performed. The majority of patients (41.5%) who did not have amniocentesis were 35 years of age at delivery. The perinatal mortality rate of the study group was similar to that of the control group. There were no maternal deaths.