PREGNANCY OUTCOME IN NULLIPAROUS WOMEN 35 YEARS AND OLDER

Objective: To compare pregnancy and delivery complications of first bi rths in women 35 years and older with women 25-29 years old. Methods: Maternal and newborn records for first births at three suburban hospit als from July 1, 1986 to June 30, 1990 were studied retrospectively. R esults: The older women differed significantly in: 1) antepartum facto rs (type of insurance, marital status, prior pregnancy experience, wei ght gain, obesity, chronic and pregnancy-induced hypertension, gestati onal diabetes [without insulin], asthma, leiomyomas, and third-trimest er bleeding), 2) intrapartum factors (anesthesia for vaginal delivery, gestational age at delivery, preterm labor, spontaneous labor, oxytoc in use, malpresentation, cesarean births, and postpartum hemorrhage), and 3) neonatal outcomes (gestational age, birth weight, preterm birth s, abnormal karyotypes, neonatal intensive care unit admissions, low b irth weight, and small for gestational age infants). Logistic regressi on determined that risk factors significantly predicting perinatal mor tality were leiomyomas (odds ratio [OR] 2.6, 95% confidence interval [ CI] 1.3-5.0), preterm birth (OR 4.9, 95% CI 3.1-7.7), and chorioamnion itis (OR 5.9, 95% CI 3.1-11.4), but not age. Conclusion: Nulliparous w omen 35 years and older had higher rates of antepartum, intrapartum, a nd newborn complications than nulliparas between the ages of 25-29 yea rs, but not an increased perinatal mortality rate. Despite the increas ed risk of complications, maternal and perinatal outcomes were good.