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Perinatal results in pregnant women with more than 35 years: a controlled study

PURPOSE: to evaluate perinatal results in pregnant women over 35 years old and to check differences between two groups: 35 to 39-year-old women and women older than 40. METHODS: a retrospective survey was made during the period between January/2000 and July/2003, through the analysis of obstetric charts of 3,093 pregnant women who delivered in the "Hospital do Servidor Público Estadual - Francisco Morato de Oliveira", excluding 933 patients. The patients were divided into 3 groups: 18 to 29 years old (control group), 35 to 39 years old, and over 40 years old. Data collection was done with standardized forms, and the data were transferred to an electronic spreadsheet (Excel - Microsoft Office 2000). Statistical analysis was performed using the chi2 test and the Fisher test. The alpha risk was less or equal to 5% and the confidence interval 95%. RESULTS: cesarean section was the most used method not only in the 35 to 39-year-old group (438/792; 55.3%) but also in the group of women over 40 (153/236; 64.8%). The rates of prematurity (39/236; 16.5%), low weight (37/236; 15.7%), and restriction of fetal growth (38/236; 16.1%) were significantly higher in the group of women over 40, when compared to the other groups. Concerning fetal death, a five times higher incidence was observed in the group over 40 years old, as compared to the other groups, a statistically significant difference. CONCLUSION: the only difference between the 35 to 39-year-old group and the control group was the cesarean section rate. This allows us to suggest a differentiated prenatal attendance for pregnant women over 40.

Maternal age; Normal pregnancy; Prematurity; Fetal growth restriction


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