Pregnancies in primiparous women 35 or older: Still risk pregnancies?

Objective: An increasing number of women are postponing childbearing. We st udied whether first pregnancies in women 35 years or older are associated w ith an increased obstetric risk. Methods: Using the Perinatal Registry of the German state of Hesse we compa red 8883 pregnancies in primiparas 35 to 39 years of age with 1269 pregnanc ies in women older than 39 years and 154,651 pregnancies in women 18 to 34 years old (control group). We compared socioeconomic data, problems during pregnancy, delivery data, and complications. Results: The incidence of obstetric risks increased with age. Problems acqu ired during pregnancy (e.g., pregnancy-induced hypertension, premature cont ractions) were increased only in the women older than 39 years. Complicatio ns during delivery were increased in both older age groups compared with th e controls. The cesarean section rate was higher in both groups of older mo thers than in the controls (35.6%, 48.0% and 27.3%, respectively). In a mul tivariate analysis maternal age was an independent risk factor for cesarean delivery. Conclusions: The incidence of risk factors during pregnancy and delivery an d the cesarean delivery rate increase with age in primiparas. The increased rate of cesarean delivery in older primiparas cannot be ascribed solely to an increased rate of complications.