Pregnancy after 40 years: Is it high risk ?

Drizis E, Prapas N, Papanikolaou A, Makedos A, Chrisohoidis C, Makedos G

4th Department of Obstetrics and Gynecology, Aristotelian University of Thessaloniki, Hippokrateio hospital, Thessaloniki, Greece.

Correspondence: Drizis E, 68 Egnatia St, GR-54624, Thessaloniki, Greece. E-mail:


Aim: To investigate the outcome of pregnancy in women over 40 years. Materials and methods: Retrospective study of the years 1994-2002. Pregnant women over 40 years of age were matched with a control group of women 20-29 years old, regarding previous history of infertility, gestational age at birth, birth weight, mode of delivery, and complications in pregnancy. Primiparous and multiparous women were compared separately. Results: In the study period, 8,114 women gave birth, and 124 (1.5%) of them were ≥40 years. 41(33%) were primiparous. Mean gestational age at delivery was shorter for primiparas ≥40 years, compared with those 20-29 years (35.1 vs 38.6 weeks) (p<0.0001). Operative delivery rates were similar in both groups, with the exception of primiparas ≥40 that had increased cesarean section rate (80% vs 13.8%) (p<0.0001). Pregnancy was complicated by new or previous disease in 63.3% of primiparas ≥40 versus 6.9% of control group (p<0.0001). Twelve primiparas ≥40 (40%), had undergone IVF vs none in the control group (p<0.0001). Mean birth weight was 2,675 g for the primiparas ≥40 years vs 3,030 g for the control group (p=0.005). Mean gestational age at birth for multiparous women ≥40 was shorter than that for younger multiparas (37.0 vs 38.5 weeks) (p<0.001). Cesarean section rate were higher in multiparas ≥40 years than younger multiparas (45.7% vs 7.9%) (p<0.0001). 27% of multiparas ≥40 years, had a pregnancy complicated by new or previous disease, compared with 6% in the control group (p<0.0001). Conclusions: Older women have increased rates of morbidity in pregnancy.

Keywords: maternal age, parity, pregnancy complications, cesarean section

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