CLINICAL ASPECTS OF PREGNANCY AFTER THE AGE OF 35 YEARS - A REVIEW OFTHE LITERATURE

The objective of this report is to provide an update of our current kn owledge about the impact of maternal age on pregnancy outcome, Pregnan cy in women greater than or equal to 35 years old is associated with a higher maternal and perinatal mortality, The older gravida also has a higher chance of being delivered by Caesarean section. Most of the co mplications associated with older age are caused by age-related confou nders such as leiomyomas, type II diabetes, hypertension and multipari ty, Diabetes and hypertension increase almost linearly with age. Pregn ant women with diabetes or hypertension are at increased risk of adver se pregnancy outcome irrespective of age. The currently available lite rature indicates that premenopausal pregnant women of advanced age who are in good health do not need special care besides the normal obstet ric practice. At present, establishing pregnancy in postmenopausal wom en is more an ethical than a medical issue, partly because the informa tion reported on pregnancy in postmenopausal women is insufficient to determine a reliable risk profile. In these women cardiovascular agein g accelerates. Therefore, until proven otherwise, postmenopausal women should be considered particularly at increased risk for vascular comp lications during pregnancy. This risk is likely to increase progressiv ely with the number of years elapsed since the onset of postmenopause.