Analysis Of Pregnancy Outcome On 454 Cases Of Aged Pregnant Women

Objective:To investigate the effect of the aged pregnant women on pregnancy course and perinatal outcome of children and mode of delivery.Methods:Cases comes from lying-in women in the First Affiliated Hospital of Dalian Medical University from January 2002 to December 2009.454 cases of pregnant women(aged 35 and older) were taken as the study group,in which there were two subgroups:the study group 1(286 cases of elderly primiparas)and the study group 2(168 cases of elderly multiparae);And non-elderly(aged from 20 to 34) 454 cases of pregnant women were taken as the control group,Its subgroups were:the control group 1 (286 cases of non-elderly primiparas) and the control group 2 (168 cases of non elderly multiparae).Retrospective and comparative study were applied to the clinical data, comparing with each group with respect to pregnancy complications, perinatal outcome of children and mode of delivery.Results:1. Pregnancy complications:â‘ Pregnancy with uterine myoma and diabetes:the study group was higher than the control group(P<0.001);the study group 1 was higher than the control group 1(P<0.05);the study group 2 was higher than the control group 2(P<0.05).â‘¡Incidence of spontaneous abortion:the study group was higher than the control group(P<0.001);the study group 1 was higher than the control group 1(P<0.001); the study group 1 was higher than the study group 2(P<0.05).2. Perinatal outcome of children:the study group only had higher incidence than the control group on FGR(P<0.05).3. Mode of delivery:â‘ Rate of cesarean section:the study group 1 was higher than the control group 1(P<0.001);the study group 2 was higher than the control group 2(P<0.05); the study group 1 was higher than the study group 2(P<0.001).â‘¡Incidence of which failed in vaginal delivery and transfer to cesarean section:the study group 2 was higher than the control group 2(P<0.05).â‘¢Laceration of soft passage:the study group 2 is higher than the study group 1 on laceration of soft passage(P<0.001).4. Indications of cesarean section:â‘ In the group 1,indication sequenced:social factors,complications in pregnancy,fetal distress,protracted stage.â‘¡The study group 1 had higher proportion on social factors than the control group 1(P<0.001), while has lower proportion on protracted stage(P<0.001).â‘¢In the group 2,indication sequenced:scared uterus, complications in pregnancy,social factors, protracted stage.Conclusion:1. Aged pregnant women had high incidence in uterine myoma and diabetes, so these women need more screening, warning its adverse complications.2. Aged pregnant women had high incidence in fetal growth restriction, It attributed to the higher incidence of pregnancy-induced hypertension in these women probably, so more antenatal care were needed,To detect and treat the disease timely, avoiding to effect the quality of the neonatus.3. Elderly primiparas's rate of cesarean section,the chief reason was the social factors; Elderly multiparae had high incidence in failure of vaginal delivery and transfer to cesarean section.It attributed to the interval(10 years and longer) between this pregnancy and the last.For these people,selecting the mode of delivery should be discreet.4. Elderly multiparae had high incidence in laceration of soft passage,If these women chose viginal delivery,On guard it,Pay more attention to protecting the perinaeum.avoiding.To avoid the laceration of soft passage.