PREGNANCY OUTCOME IN ADVANCED MATERNAL AGE IN COMPARISON WITH YOUNGER PREGNANT WOMEN – A COMPARATIVE STUDY IN CENTRAL REFERRAL HOSPITAL, GANGTOK, SIKKIM

Abstract

Objectives: The aim of the study was to compare maternal and neonatal outcome in pregnancy in advanced maternal age (>35 years) in comparison with pregnancy outcome in younger mothers of age 20–34 years. Methods: This was a retrospective and comparative study conducted in the Department of Obstetrics and Gynecology of Central Referral Hospital, Gangtok, Sikkim. Institutional ethical committee approved the study. One thousand three hundred and thirty-five women were included in this study. Data of these mothers were retrieved from the MRD records and reviewed. Pregnancy outcomes were studied in terms of antenatal, intranatal, and postpartum complications. Each adverse obstetrical outcome was assessed if it has made a significant association with maternal age. Perinatal outcome was also compared. Results: The mean maternal age was significantly higher in Group A (38.2±0.66) as compared to Group Y (25.85±4.41) and the difference was found to be statistically highly significant (p<0.0001). LSCS rate was more in advanced maternal age group as compared to patients <35 years and the difference was statistically significant (p=0.0009). Comparison for both the groups for gestational diabetes, gestational hypertension, anemia, preterm labor, prelabor rupture of membranes, and postpartum hemorrhage shows these pathologies to be more common in Group A. In Group A, the common causes of LSCS were patient request (41.39%) followed by FGR with abnormal Doppler (26.01%) whereas in Group Y common indications for LSCS included previous LSCS (36.56%) patient request (27.56%). Group A had a higher incidence of low birth weight (52 vs. 65, p<0.0001), large-for-gestational-age babies (>4 kg) (15 vs. 12, p<0.0001), NICU admission due to low APGAR score (35 vs. 42, p<0.0001), and pre-term births (43 vs. 10, p<0.0001). Conclusion: Advanced maternal age pregnancies are associated with increased incidence of maternal medical disorders, cesarean section, and postpartum haemorrhage as well as adverse perinatal outcome.