The Impact of Extreme Maternal Ages on Hypertensive Disorders of Pregnancy: A Retrospective Cohort Study in Dakar, Senegal

Abstract

Background: Hypertensive disorders of pregnancy are a frequent situation and involve about 8% - 10% of pregnancies. Extremes maternal ages have been associated to hypertensive disorders of pregnancy. In Africa, even if motherhood in teens is common, pregnancy at advanced age is getting more and more frequent. Objectives: To investigate the relation between maternal age and hypertensive disorders of pregnancy. Methods: A retrospective cohort study over 8 years was conducted in a suburb setting in Dakar, Senegal. The participants were divided into two groups based on the occurrence of hypertensive disorders of pregnancy (HDP). Data were extracted from E-Perinatal, our electronic medical recording system and analyzed using SPSS 20.0 and R Studio software version 1.1.383.51. Maternal and perinatal outcomes were assessed over 3 age groups: 34 years and 19 - 34 years old. Results: The study included 2226 cases of HDP out of 36,499 deliveries leading to an incidence of 6.1%. The proportions of nulliparous, multiple pregnancies and maternal diabetes were higher in women with HDP. The risk of high blood pressure among mothers aged 35 years and over was 1.6 times as high as the risk among those aged 19 - 34 years at a significant level before and after adjusting for third factors i.e. parity, multiple pregnancy and diabetes. However, adolescents were found to have the same risk compared to their counterparts aged 19 - 34 years. Risk of eclampsia was 4 times greater among adolescent girls. Conclusion: Advanced maternal age greater than or equal to 35 years is a risk factor for high blood pressure. There is no extra risk in adolescent girls with regard to high blood pressure; however, risk of eclampsia was higher in this group.