Perinatal outcome in primiparous women aged 35 and older: a case-control study.

Unlabelled: Women who delay childbearing are at increased risk for complications in pregnancy and delivery.

Aim: The aim of this study was to determine whether primiparas > or = 35 have worse perinatal outcome compared to primiparas aged 20-27.

Patients And Methods: The perinatal outcome of 240 primiparas who gave singleton birth at Mostar Clinical Hospital between January 1, 2002 and December 31, 2004 was analyzed. Observed group was formed by 120 primiparas aged > or = 35. The control group was formed in the manner that each primipara from the observed group was assigned the first primipara younger than 35 with a singleton gestation who was subsequently entered in the delivery room record book. The data were collected from the maternal and newborn medical records at Mostar Clinical Hospital within the observed period.

Results: Significantly higher occurrence of cesarean section (p < 0.001; OR = 2.6; 95% CI 2.32-2.90), preterm delivery (p < 0.001; OR = 4.8; 95% CI 4.51-5.09), newborn of low birth weight < 2500 g (p < 0.034; OR = 2.6; 95% CI 2.34-2.92) and neonatal intensive care unit admission (OR = 2.7; 95% CI 2.47-3.05) were observed in primiparas aged > or = 35. The perinatal mortality was also significantly higher in the group of the older primiparas (p = 0.020; OR = 7.8; 95% CI 7.55-8.13).

Conclusion: The overall results and a significantly higher number of perinatal deaths in particular present a significant concern because of growing number of older primiparas over the last decades.