Pregnancy outcome in the elderly gravida in Addis Ababa.

OBJECTIVE

To determine the difference in selected antepartum obstetric problems and pregnancy outcome between women delivering at the age of 35 or above and women delivering at the age of 20-34 in the Ethiopian setting.

DESIGN

A prospective case control study.

SETTING

Saint Paul's and Tikur Anbessa Teaching Hospitals, Faculty of Medicine, Department of Obstetrics and Gynaecology, Addis Ababa University, Addis Ababa, Ethiopia.

SUBJECTS: A hundred and seventy four gravidae delivering at the age of 35 or above and 174 gravidae delivering at the age of 20-34 from December 1,1997 to August 30,1998 in the above setting fulfilling inclusion criteria were cases and controls respectively.

MAIN OUTCOME MEASURES: Included current obstetric problems, labour induction, operative delivery, low birthweight, apgar scores, prenatal death, neonatal intensive care admission rates and mean foetal birthweight.

RESULTS

Pregnancy at old age was more likely to be complicated by hypertension (p<0.05, OR=2, 95% CI=1.04-4). Cases were more likely to undergo induction of labour (p<0.0001, OR=2.3, 95% CI=2.7-12) than controls. Although the rates of poor foetal and neonatal outcome indices seem to increase for the older gravidae, the difference was not statistically significant.

CONCLUSION

Consistent with other studies, hypertension was the most common disorder complicating pregnancy at age 35 and above. Cases were more likely to undergo induction of labour and operative delivery. Larger studies are needed to establish the exact magnitude of these associations and to show any significant difference in antepartum obstetric problems and fetal and neonatal outcome measures.