Does parity affect pregnancy outcomes in the elderly gravida?
To identify whether older primiparas have more complications than do women who continue to deliver children into their late reproductive age. Patients of at least 35 years of age at delivery were included. Within this cohort, data from primiparous and multiparous women were compared.
This retrospective study was based on electronic medical records from a single academic center, with more than 7000 deliveries annually. The impact of parity on maternal complications was assessed using a multivariate logistic regression model that adjusted for baseline maternal characteristics and medical history.
During the study period, there were 54 283 deliveries in our medical center. A total of 13,982 (25.7%) patients were at least 35 years old at delivery. The rate of twin pregnancy was higher in the primiparous group (1.9%) as compared to the multiparous group (0.8%, 95% CI 0.30–0.64, P < 0.001), as was the incidence of delivery prior to 34 weeks (6.1% of the primiparas versus 2.9% of the multiparas, P < 0.001, OR 2.16, 95% CI 1.75–2.68); hypertensive disorders (3.9% versus 1.7%, P < 0.001, 95% CI 0.33–0.57); diabetes (4.6% versus 3.2%, P = 0.003, 95% CI 0.55–0.88); and IUGR (10.5% versus 4.7%, P < 0.001, 95% CI 0.35–049), respectively. The increased risk for pre-term delivery, hypertensive disorders, diabetes, and IUGR was maintained after logistic regression analysis.
We found that pregnancy complications typical to older parous women are significantly more common among primiparas, indicating that not only older age, but also having a first child relatively late in the reproductive period contributes to adverse pregnancy outcomes.
KeywordsAdvanced maternal age Elderly gravida Parity Pregnancy complications Pregnancy outcome Primiparity
We thank Navah Jelin, MSc for help with the statistical analysis and Faye Schreiber, MSc for editing the manuscript.
GSM: literature review, data collection, writing manuscript, and data analysis; DS-M: data collection, manuscript writing; YG-P: data collection, and manuscript writing; RSH: manuscript writing; OM: manuscript writing; TB-S: data analysis and manuscript writing.
The study was not funded.
Compliance with ethical standards
Conflict of interest
The authors report no conflict of interest.
The Meir Medical Center Ethics Committee reviewed and approved the study. The study data were obtained from the hospital database and informed consent was not required.
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