Elderly primigravidae versus young primigravidae in najaf governorate (pregnancy outcome regarding antenatal, peripartum and postpartum occurrences)

Background: The elderly primigravida defined as a woman who goes into pregnancy for the first time at the age of 35 years or older. This has become more common in many societies and traditionally such pregnancy regarded as a high risk pregnancy. Objectives: To determine and compare the pregnancy outcome in elderly primigravidae aged 35 years old and above with those of young primigravidae (less than 35 years old). Study design: A prospective case control study that involves comparing pregnancy ( peripartum and postpartum) outcome in primigravidae aged more than 35 years old to those who are younger than 35 years old whom were admitted to Al-Zahra teaching Maternity hospital and Al-Hakeem general hospital in Najaf. Material and Method: Pregnant women were divided into 2 groups: the first group involved pregnant women whom age was more than 35 years old (old primigravidae /case group) and the second group which involved pregnant women with less than 35 years old (young primigravidae/control group). Both groups were delivered by either vaginal delivery or by caesarian section. A complete history was taken from each patient in form of maternal age, gestational age, any history of infertility abortion, chronic hypertension ,preeclampsia (PET), preexisting or gestational diabetes, uterine fibroid and ante partum hemorrhage ,then vital signs was measured and routine investigation in the hospital was done. Results: A total of 140 pregnant women were involved in this study of whom 50 were in the old primigravidae group. History of infertility was higher in the old primigravida group. No significant differences were observed between both studied groups in respect of gestational age and socio-economic status. The prevalence of chronic hypertension and the incidence of preeclampsia, intra uterine death and associated uterine fibroid were statistically higher in old primigravidae than young primigravidae. Other complications such as diabetes and ante partum hemorrhage were not significantly different between the two groups. Regarding mode of delivery; caesarean section was indicated in a significantly higher proportion of old primigravidae than that of young primigravidae. Conclusion: Elderly primigravidae have higher risk for developing of some of pregnancy associated complications requiring special care and timely recognition for better outcome.