Pregnancy adverse outcomes in Tunisian women over 40 years

 

 

Objective:

Describe maternal-fetal prognosis of pregnancies at an age greater than or equal to 40 years in Tunisian women.

Design: Retrospective case control comparative study over a period of 2 years (January 2020 to December 2022).

Methods:

We enrolled 222 pregnant women who delivered in the department of Gynecology and Ben Arous regional hospital and divided them into two groups according to their age:

Groupe 1: age ≥40 years (n=227)

Groupe 2: control group (n= 227)

We compared maternal-fetal outcomes between the two groups.

Results:

First trimester averse outcomes were more frequent in group 1 than in group 2: ongoing abortions, terminated pregnancies, scar pregnancies and extra uterine pregnancies. However, the difference was not significant (15% vs. 29%, p=0.931).

Over all second and third trimester adverse outcomes were significantly more frequent in group 1 than in group 2: pre-eclampsia (11.8% vs 6.6%, p=0.0077), premature rupture of membranes (40% vs 18%; p<0.001), in utero fetal death (2.5% vs 0.7%; p=0.178), diabetes (55.2% Vs 23.8%; p<0.001), preterm delivery (15.8% vs. 6.6%; p=0.003).

Scheduled caesarean sections were significantly more frequent in group 1 (111 vs 55; p<0.001). The average birth weight of the baby was 3315.1 g [550-5400g] in group 1 versus 3350.6 g [590-4800] in group 2 with a non-significant difference (p=0.529). The rate of hospitalisation in the neonatal unit was 10% in group 1 compared to 7% in group 2 with a non-significant difference p=0.246%.

 

Conclusion:

Pregnancy at an advanced age can lead to many maternal-and fetal adverse outcomes. Therefore, it requires a close follow-up in order to enhance its prognosis.