PREGNANCY OUTCOME IN NULLIPAROUS WOMEN AGED 35 OR OLDER

OBJECTIVE: Our objective was to test the hypothesis that pregnancies b eyond 20 weeks in women aged 35 or older are high-risk pregnancies. ST UDY DESIGN: Pregnancies of 857 women aged 35 and older were compared w ith pregnancies of 1597 women aged 20 to 29 with respect to pregnancy complications and outcome. All women received prenatal care and were d elivered at our institution. Data were collected prospectively and sto red in a data base. The chi2 test was used to identify trends in indiv idual variables and outcomes. Logistic regression analysis was used to examine the relationship between maternal age and delivery by cesarea n section. RESULTS: Women aged 35 or older had cesarean deliveries twi ce as often as women 20 to 29 years old. This statistically significan t difference was not accounted for by the modestly higher rates of fet al distress, placenta previa, multiple gestation, abnormal labor, or m alpresentation found in the older group. Cord blood gas values and 5-m inute Apgar scores did not differ between the two groups. There was no difference in neonatal morbidity or mortality. CONCLUSIONS: Women of 35 or older are more likely than those in their 20s to have cesarean d eliveries. The excess rate of cesarean section is only partially accou nted for by gestational complications.