Original scientific paper
Perinatal Outcome of Pregnancies in Women Aged 40 and Over
T. Miletić
N. Aberle
F. Mikulandra
D. Karelović
Z. Zakanj
I. Banović
I. Tadin
M. Periša
M. Ognjenović
T. Tadić
Abstract
Perinatal outcome of pregnancies at forty and over was analyzed starting from the
diagnosis of pregnancy to seven days following delivery. Retrospectively, pre-gestational
health and reproduction status were dealt with, as well as the course of pregnancy, deliveries,
and newborn children (study group). The control group was composed of pregnant
women aged 20 to 29, who were identical to study group in terms of parity. Statistical
data processing was done by means of 2-test, and contingency 2 2 tables. The difference
was significant if p < 0.05. Out of 2,099 diagnosed wanted pregnancies at forty
and over, 415 (19.8%) had a miscarriage, in 33 (1.6%) an artificial abortion was performed
after determining the fetus karyotype and 1,651 (78.2%) of pregnant women delivered.
In 66.2% of pregnancies the fetus karyotype was determined and in 33 (2.5%) fetuses
chromosomal abnormalities were found. Incidence of deliveries at 40 and over is
1.38%, which is a 35.6-percent increase in the last ten years. Nullipara and pluripara
had an increase, and multipara had a decrease. Pre-gestational health and reproduction
status in study group is lower than in control group. Complications during pregnancy:
threatened abortion, EPH gestosis, placenta praevia, gestational diabetes, late
fetal death are more frequent than in control group (p < 0.05). In intrapartal terms,
more frequent were induction of delivery, meconium-stainedamniotic fluid, fetal distress,
operative vaginal deliveries, and Caesarian section (p < 0.05). In neonatal outcome
there are more premature infant, there are more VLBW, LBW, SGA, newborn with
low Apgar index values, and the total perinatal death is greater than in the control
group (p < 0.05). In perinatal terms, (from the diagnosis to the seventh day following delivery)
1,617 children survived (77.0%), meaning that perinatal loss was 482 (23.0%).
Authors conclude that pregnancy at 40 and over is a high-risk pregnancy. There is a
high risk of pre-gestational and gestational complications, and perinatal loss is high.
Therefore, those pregnancies are not desirable from the medical point of view.
Keywords
Hrčak ID:
28266
URI
Publication date:
17.6.2002.
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