Abstract
Women who conceive at advance age are at risk of pregnancy complications and adverse foetal outcome. This study aims to find out the prevalence of pregnancy at advance age in a teaching hospital. A descriptive cross-sectional study was conducted between October 2019 to August 2020 at department of obstetrics and gynaecology of a tertiary care centre of Nepal, after obtaining ethical clearance from Institutional Review Committee (dated 03/09/2019 with ref no. 266) and informed consent from patient. Convenience sampling was done. All the patient who were ≥35 years and >28 weeks of gestation without any chronic illness were selected. Data and descriptive analysis were done using Statistical Package for the Social Sciences version 16. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. Women aged 35 years and above constituted 104 (5.73%) of the total deliveries of study period. Most were multigravida 72 (69.23%) and 23 (22.12%) had preterm delivery. Rate of caesarean section were higher in advance maternal age 69 (66.35%). Maternal complications such as Hypertensive disorder of pregnancy 9 (8.65%), and mal-presentation 15 (14.42%) were higher among them. Perinatal outcome in form of low birth weight 9 (8.65%) and perinatal death 5 (4.80%) were increased in those women. From this study, it can be concluded that prevalence of advanced age at pregnancy was lower than study done in developed country but it was similar to study in India and is increasing in Nepal.
Highlights
Women who conceive at advance age are at risk of pregnancy complications and adverse foetal outcome
It was observed that multigravida 72 (69.23%) were more common in advanced maternal age
In Canada, there has been an increase in the percentage of births from women aged between 35–39 years, ranging from 4.7% in 1982 to 14.1% in 2002.4 The incidence of pregnancy at advanced maternal age in US was reported as 23% in 2014 and 4.5% from India by Ritu, et al
Summary
Women who conceive at advance age are at risk of pregnancy complications and adverse foetal outcome. A study done in 29 countries revealed average prevalence of advanced maternal age was 12.3% and 2.8% in Nepal.. Pregnancy with advanced age has been increasing in developing countries like ours, limited study has been conducted to identify adverse outcome of pregnancy at advance age. Neonates are affected due to prematurity, low birth weight, Intra Uterine Growth Restriction, and foetal distress, which increase rates of Neonatal Intensive Care Unit admission. These increased risks appeared to be independent of maternal co-morbidities.
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