K - NeuroCentrum



Department of Obstetrics Medical University of Gdansk

Klinika Położnictwa Gdańskiego Uniwersytetu Medycznego

Dariusz Lautenbach, Karolina Domaracka,

PAWEł SOCHA, RAFAł BRZEZIńSKI, MAłGORZATA BARTOSEK , KRZYSZTOF PREIS

PREGNANCY AND LABOUR IN WOMEN AGED 35 AND OVER

Ciąża i poród u kobiet po 35 roku życia

Maternity is one of the most important, lasting and intensive human relations [4]. It is always a great challenge for women causing joy and concern. Maternity is mainly related with young mothers because there is a strong belief that women should get pregnant for the first time in the optimal childbearing age, which is between 20 and 30 years old [14]. From the medical point of view there is no doubt that this is the best time for a woman to give birth to a child. Young women get pregnant easier, suffer from a long term condition more seldom, adapt to changes during pregnancy easily and give birth to a child in a natural way without any complications in due date. However, social, economic, and civilization development has caused that more and more women are deciding to give birth to a child when they are over 35 [17].

The criteria of late maternity has changed over the years. In 1958 International Federation of Gynecology and Obstetrics recommended that a woman who gave birth to her first child at the age of 35 is an old primipara. Nowadays a safe maternal age is 40 years old or even more [17]. However, the term of mature maternity refers to all women giving birth after 35 including multigravida.

Over the last decades there has been a great increase in the number of women who have decided on late maternity. In highly developed countries, such as Finland and Sweden, late maternity has become a great phenomenon over the last three decades [5]. In 1997 in Finland women over 35 constituted 8,3% of all primipara and until 2007 this figure raised up to 10,4% [13]. Similarly, in Sweden in 2007 women at the age of 35 or over constituted about 10% of all primipara [13]. In Poland the number of women over 35 who decide on maternity is also increasing. In 1980 1351 women aged 35 and older gave birth to their first child. In comparison, in 2005 there were 4603 women [15]. It is estimated that every 10th child in Poland is born by a woman who is about 40 years old [15]. The number of women over 35 has increased

by 100% over the last decade. The reason for that is that women want to play a more active role in a social and working life. Most of them first concentrates on achieving good education, social and professional status and later consciously plan their maternity. The development of medicine, access to effective hormonal contraception, the development of new methods of assisted reproductive technology, which help older women get pregnant, are other reasons why women put off the decision of getting pregnant.

However, women aged 35 and older are more likely to suffer from perinatal complications. There is also an increased risk of an early miscarriage and genetic disorders [8,19]. Research results prove the higher percentage of Caesarean sections, the risk of gestational diabetes, pre-eclampsia and premature labour in this group of women [3, 8, 11, 12, 15, 17]. Most researcher have not noticed a higher perinatal mortality rate [9]. Thanks to the physiology of reproductive system it is known that anovulatory cycles occur more often with women over 35 and the chances of getting pregnant are lower. An additional factor that might have an influence on pregnancy and labour development are different disorders that occur with age, such as circulatory system disorders, hypertension, diabetes, thyroid disorders. Late maternity may cause many problems and dilemmas that is why women’s pregnancies in this age group are treated by gynaecologists and obstetricians as being at greater risk of having complications.

The aim of the study was the assessment of the pregnancy development and the first labour among 35-year-old women and older.

MATERIAL AND METHOD

Research material has been received by a retrospective analysis of medical documentation. The research involved 95 women at the age of 35 and over who gave birth to their first child at Obstetrics Clinic of Medical University of Gdansk from 1 January 2011 to 31 December 2011 inclusive.

Primipara were divided into two age groups: 35-39 years old (84 women) and 40 and over (11 women). The youngest of the women was 35 at the time of giving birth to a child and the oldest – 42.

The way of labour was divided into: natural childbirth, forceps delivery, and Caesarean section. The reasons of Caesarean section and the frequency of premature birth were studied. The research included the frequency of occurring certain mother’s diseases before getting pregnant, such as hypothyroidism and hypertension. The frequency of gestational diabetes (GDM), pregnancy-induced hypertension (PIH), and pre-labour rupture of membranes (PROM).

Received data was statistically analysed, significance level of p ................
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