ผลกระทบของมารดาที่มีอายุมากต่อผลลัพธ์ของการตั้งครรภ์

บทคัดย่อ

Objectives : To determine maternal characteristics, antepartum complications, mode of delivery, indications for cesarean section, postpartum complications and neonatal outcomes in pregnant women aged 35 years or older.

Materials and methods : This was a retrospective cohort study. The labour records of 611 singleton pregnant women aged 35 years or older at the time of delivery who delivered in the labour room, Nakhonpathom hospital during October 1, 2008 - September 30, 2009 (study group) were reviewed and compared with a control group consisting of 3,498 singleton pregnant women aged 20-34 years at the time of delivery who delivered during the same period. The cases of delivering before 20 weeks gestation and of babies weighing < 500 gram were excluded from both groups.

Results : Compared with the younger control group, women aged 35 years or older had significantly higher risks of HIV seropositive, DM, heart diseases, chronic hypertension, preterm, postterm, placenta previa and mild PIH. They were also at significantly increased risks of cesarean section, breech assisting and vacuum extraction respectively. Most common indications for cesarean section in the older group were previous cesarean section, CPD and elective cesarean section respectively. In addition, the risks of puerperal infection, hysterectomy and rectal tear increased in the older group, including the risks of macrosomia, stillbirth, early neonatal death and low Apgar scores.

Conclusion : Advanced maternal age was associated with significantly elevated risks for pregnancy complications and adverse outcomes.