Obstetric performance of elderly primi gravida in Jos University teaching hospital, Jos, Nigeria.

Abstract

Background: Obstetric complications have been associated with elderly primigravidaeworld wide and they continue to increase hence the need to review obstetric performance of elderly primigravida.
Objective: To compare the maternal and perinatal outcome of nulliparous women aged 35 years and older at time of delivery to that of nulliparous women aged 20-34 years old in Jos University Teaching Hospital.
Methods: A one year prospective study was carried out on allprimigravid women with singleton pregnancy that came to deliver in the labour ward unit of Jos University Teaching Hospital (JUTH), JosNigeria from 1st May, 2010 to 30th April,2011
Main outcome measures: gestational diabetes, chronic and pregnancy induced hypertension, antepartum haemorrhage, prelabour rupture of membranes, and preterm labour, breech presentation, cephalopelvic disproportion, failure to progress,increased cesarean deliveries, fetal asphyxia. 
Results: Maternal age of thirty five years and older at the time of first child birth had higher obstetric and perinatal complications than younger maternal age group.During the study period, 411 primigravidae delivered in the labour ward unit of Jos University Teaching Hospital. Out of these, 397 (96.6%) were aged ≤ 34 years while only 14 (3.4%) were aged ≥ 35 years. The commonest obstetric complication was failure to progress in labour (FTP),18(4.4%). Three hundred and thirteen (76.2%) of the women had spontaneous vaginal delivery, 97(23.6%) had caesarean delivery while 1(0.2%) had assisted vaginal delivery using vacuum. Twenty three (5.6%) of the babies were asphyxiated while 382(92.9%) were of normal APGAR scores.

Conclusion: Maternal age of thirty five years and older at the time of first child birth had higher obstetric and perinatal complications than younger maternal age group. Women who were thirty five years and older at the time of first delivery had worse maternal and perinatal outcome than women who were thirty four years and younger at the time of first delivery.

Keywords: Obstetric, Elderly, primigravida, Nulliparous, Maternal age, perinatal.