A study to evaluate the maternal and fetal outcome in advanced maternal age.

Abstract

Background: The present study is aimed (a) To evaluate the association between advanced maternal age at birth and caesarean section (CS) (b) To study the perinatal outcome in pregnancy with advanced maternal age. Materials and Methods: This retrospective study was conducted to evaluate maternal and fetal complications associated with maternal age of pregnancies at ≥30 years was carried out in the Department of Obstetrics and Gynecology, Sri Devaraj Urs Medical College, attached to RL Jalappa Hospital and Research Centre, Kolar between Jan 2019 and December 2019, after fulfilling all the inclusion and exclusion criteria. Data of 200 women were collected from the parturition register. The major maternal parameters studied were age at the time of delivery, parity, gestational age, booking status, mode of delivery. The obstetric complications like preeclampsia, gestational diabetes mellitus, postpartum hemorrhage, PROM, and hypothyroidism. Fetal parameters studied were fetal distress, thick meconium-stained liquor, macrosomia, perinatal asphyxia and fetal growth restriction. Results: In this study, out of 200 women, 166 (83%) were in the age group of 30-34 years. Out of 200 women, 90 (45%) patients required caesarean section whereas 104 (52%) women had full term normal deliveries and operative vaginal delivery in 6 (3%). Among all the women, who underwent caesarean section (90), indication for caesarean section was thick meconium-stained liquor with poor bishop score in 26 (13%) subjects. Severe oligohydramnios was observed in 13 (6.5%) cases, followed by isolated fetal distress in 15 (7.5%) cases. Maternal and obstetric complications have been observed in 84 women. The maternal complications such as preeclampsia was observed in 40 (20%), gestational diabetes mellitus in 11 (5.5%), followed by hypothyroidism in 10 (5%). Concerned with the fetal outcome, 170 (85%) babies were shifted to mother side, while 30 (15%) babies were admitted to NICU due to various fetal complications. Fetal complications, such as fetal distress was seen in 10 (5%) babies and thick meconium-stained liquor in 7 (3.5%) babies followed by 5 (2.5%) babies were FGR. However, no neonatal deaths were recorded in this study. Conclusion: The present study results may conclude the evidence that caesarean section rates increase with advancing maternal age. Maternal age ≥ 30 years older had a higher overall prevalence of obstetrical complications such as preeclampsia, gestational diabetes mellitus, and hypothyroidism. The fetal complications such as fetal distress, thick meconium-stained liquor and FGR. Need for neonatal care also to be considered in pregnancies with advanced maternal age. The possible benefits of elective caesarean section may include pelvic floor protection, convenience, reduced fear of childbirth and the reduced risk of some fetal injuries.