Author:
- ABSTRACT.
- INTRODUCTION
- MATERIALS AND METHODS
- STATISTICAL ANALYSES
- RESULTS
- Sociodemographic characteristics of study participants.
- Obstetric and gynecological history.
- Maternal and fetal outcomes.
- Modified Poisson regression for maternal outcomes of elderly primigravidae compared with younger primigravidae.
- Modified Poisson regression for fetal outcomes of elderly primigravidae compared with younger primigravidae.
- DISCUSSION
- CONCLUSION
- Supplemental Materials
- ACKNOWLEDGMENTS
- REFERENCES
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Moses V, Dalal N, 2016. Pregnancy outcome in elderly primi gravidas. Int J Reprod Contracept Obstet Gynecol 5: 3731–3735.
-
2.
Laopaiboon M, Lumbiganon P, Intarut N, Mori R, Ganchimeg T, Vogel JP, Souza JP, Gülmezoglu AM; WHO Multicountry Survey on Maternal Newborn Health Research Network, 2014. Advanced maternal age and pregnancy outcomes: A multicountry assessment. BJOG 121: 49–56.
-
3.
Ghana Statistical Service, 2014. Demographic and Health Survey 2014. Accra, Ghana: Ghana Statistical Service.
-
4.
Rademaker D, Hukkelhoven CWPM, van Pampus MG, 2021. Adverse maternal and perinatal pregnancy outcomes related to very advanced maternal age in primigravida and multigravida in The Netherlands: A population-based cohort. Acta Obstet Gynecol Scand 100: 941–948.
-
5.
Nojomi M, Haghighi L, Bijari B, Rezvani L, Tabatabaee SK, 2010. Delayed childbearing: Pregnancy and maternal outcomes. Int J Reprod BioMed 8: 80–85.
-
6.
Verma S, 2009. Advanced maternal age and obstetric performance. Apollo Med 6: 258–263.
-
7.
Olusanya BO, Solanke OA, 2012. Perinatal correlates of delayed childbearing in a developing country. Arch Gynecol Obstet 285: 951–957.
-
8.
Creanga AA, Gillespie D, Karklins S, Tsui AO, 2011. Low use of contraception among poor women in Africa: An equity issue. Bull World Health Organ 89: 258–266.
-
9.
Attali E, Yogev Y, 2021. The impact of advanced maternal age on pregnancy outcome. Best Pract Res Clin Obstet Gynaecol 70: 2–9.
-
10.
Oppong SA, Torto M, Beyuo T, 2020. Risk factors and pregnancy outcome in women aged over 40 years at Korle-Bu Teaching Hospital in Accra, Ghana. Int J Gynaecol Obstet 149: 56–60.
-
11.
Odame Anto E, Owiredu WKBA, Sakyi SA, Turpin CA, Ephraim RKD, Fondjo LA, Obirikorang C, Adua E, Acheampong E, 2018. Adverse pregnancy outcomes and imbalance in angiogenic growth mediators and oxidative stress biomarkers is associated with advanced maternal age births: A prospective cohort study in Ghana. PLoS One 13: e0200581.
-
12.
Biney AAE, Nyarko P, 2017. Is a woman’s first pregnancy outcome related to her years of schooling? An assessment of women’s adolescent pregnancy outcomes and subsequent educational attainment in Ghana. Reprod Health 14: 123.
-
13.
Yussif A-S, Lassey A, Ganyaglo GY, Kantelhardt EJ, Kielstein H, 2017. The long-term effects of adolescent pregnancies in a community in Northern Ghana on subsequent pregnancies and births of the young mothers. Reprod Health 14: 178.
-
14.
Opadiran RO, Isah AD, Adewole N, Omonua KI, 2018. Pregnancy outcome in elderly primigravidae at a Nigerian Tertiary Hospital: A five-year review. Int J Reprod Contracept Obstet Gynecol 7: 391–395.
-
15.
Anozie OB, Mamah JE, Esike CU, Asiegbu OG, Lawani LO, Eze JN, Onoh RC, 2019. Pregnancy outcome among elderly primigravidae: A five-year review at Abakaliki, Ebonyi State, Nigeria. JCDR 13: QC01–QC04.
-
16.
Morris JM, Totterdell J, Bin YS, Ford JB, Roberts CL, 2018. Contribution of maternal age, medical and obstetric history to maternal and perinatal morbidity/mortality for women aged 35 or older. Aust N Z J Obstet Gynaecol 58: 91–97.
-
17.
Dixit PV, Mehendale MA, 2017. Study of pregnancy outcome in elderly gravida. Int J Reprod Contracept Obstet Gynecol 6: 5384–5389.
-
18.
Islam MM, Bakheit CS, 2015. Advanced maternal age and risks for adverse pregnancy outcomes: A population-based study in Oman. Health Care Women Int 36: 1081–1103.
-
19.
Jeong Y, Choo SP, Yun J, Kim EH, 2021. Effect of maternal age on maternal and perinatal outcomes including Cesarean delivery following induction of labor in uncomplicated elderly primigravidae. Medicine (Baltimore) 100: e27063.
-
20.
Gupta M, Saini V, 2018. Cesarean section: Mortality and morbidity. JCDR 12: QE01–QE06.
-
21.
Sobhy S et al., 2019. Maternal and perinatal mortality and complications associated with caesarean section in low-income and middle-income countries: A systematic review and meta-analysis. Lancet 393: 1973–1982.
-
22.
Sandall J et al., 2018. Short-term and long-term effects of Caesarean section on the health of women and children. Lancet 392: 1349–1357.
-
23.
Uchenna OVJ, Okwuchukwu OV, Ifunanya NJ, Idzuinya OB, Chibuzor UD-P, Nobert OC, Chukwu IC, Joy AC, 2019. Pregnancy outcome in elderly primigravidae: A 5-year review in a tertiary health care institution in Abakaliki, Southeast, Nigeria. Am J Clin Med Res 7: 44–47.
-
24.
Ben-David A, Glasser S, Schiff E, Zahav AS, Boyko V, Lerner-Geva L, 2016. Pregnancy and birth outcomes among primiparae at very advanced maternal age: At what price? Matern Child Health J 20: 833–842.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 1013 | 1013 | 127 |
| Full Text Views | 18 | 18 | 1 |
| PDF Downloads | 21 | 21 | 0 |
Pregnancy Outcomes of Elderly Primigravidae in a Tertiary Hospital in West Africa: A Retrospective Cohort Study
Kwaku Asah-Opoku
Kwaku Asah-Opoku
Department of Obstetrics and Gynaecology, University of Ghana Medical School, University of Ghana, Accra, Ghana;
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Kareem Mumuni
mumunikareem@yahoo.co.uk
Kareem Mumuni
Department of Obstetrics and Gynaecology, University of Ghana Medical School, University of Ghana, Accra, Ghana;
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Michael Ntumy
Michael Ntumy
Department of Obstetrics and Gynaecology, University of Ghana Medical School, University of Ghana, Accra, Ghana;
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Theodore Boafor
Theodore Boafor
Department of Obstetrics and Gynaecology, University of Ghana Medical School, University of Ghana, Accra, Ghana;
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Donne Kofi Ameme
Donne Kofi Ameme
Ghana Field Epidemiology and Laboratory Training Program, University of Ghana School of Public Health, Accra, Ghana;
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Maxfield Okere
Maxfield Okere
Department of Obstetrics and Gynaecology, Korle-Bu Teaching Hospital, Accra, Ghana;
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Anthony Godi
Anthony Godi
Department of Biostatistics, School of Public Health, University of Ghana, Accra, Ghana
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Samuel A. Oppong
Samuel A. Oppong
Department of Obstetrics and Gynaecology, University of Ghana Medical School, University of Ghana, Accra, Ghana;
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Ali Samba
Ali Samba
Department of Obstetrics and Gynaecology, University of Ghana Medical School, University of Ghana, Accra, Ghana;
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ABSTRACT.
Elderly primigravidae refers to women who become pregnant for the first time from age 35 years and above. Advanced maternal age is a known risk factor for numerous maternal and perinatal complications. This study sought to determine pregnancy outcomes of elderly primigravidae at the Korle-Bu Teaching Hospital (KBTH). A retrospective cohort study was conducted. Women who had their first delivery at KBTH from January 1, 2015 to December 31, 2017 had their demographic and obstetrics and gynecology history and maternal and fetal outcomes retrieved from the department’s electronic database. Women aged 35 years or more who had their first delivery within the study period constituted the exposed, whereas those between 20 and 34 were considered unexposed. Modified Poisson regression with robust error variance estimation and the log link function between the sociodemographic and obstetric factors and maternal and fetal outcomes to estimate adjusted risk ratios (aRRs) and 95% CI were used. Of 29,243 total deliveries, elderly primigravidae constituted 1.81% (530/29,243). Maternal outcomes associated with elderly primigravidae were increased incidence of Caesarean section or instrument delivery (aRR [95% CI] = 1.73 [1.56–1.92]) and prolonged length of stay in hospital (aRR [95% CI] = 1.14 [1.06–1.23]). Fetal outcome associated with the elderly primigravidae was stillbirth (aRR [95% CI] = 1.91 [1.25–2.91]). Elderly primigravidae therefore require more intensive monitoring, even in the absence of any obvious maternal complications. These findings will help in counseling and in the shared decision-making for delivery of elderly primigravidae.
- Supplemental Materials (PDF 255.54 KB)
Author Notes
Financial support:
Disclosure: Ethical clearance was obtained from the Ethical and Protocol Review Board of the College of Health Sciences of the University of Ghana with ethical clearance number CHS-Et/M.2–3.7/2018–2019. Permission was also obtained from the Department of Obstetrics and Gynaecology of the KBTH to perform the study in the department. The study did not involve direct interaction with the women. All data used were abstracted from the records.
Current contact information: Kwaku Asah-Opoku, Kareem Mumuni, Michael Ntumy, Theodore Boafor, Samuel A. Oppong, and Ali Samba, Department of Obstetrics and Gynaecology, University of Ghana Medical School, University of Ghana, Accra, Ghana, E-mails: kasahopku@yahoo.com, mumunikareem@yahoo.co.uk, myntumy2018@gmail.com, theodoreboafor@gmail.com, saoppong@ug.edu.gh, and abmasa@yahoo.com. Donne Kofi Ameme, Ghana Field Epidemiology and Laboratory Training Program, University of Ghana School of Public Health, Accra, Ghana, E-mail: amemedonne@yahoo.com. Maxfield Okere, Department of Obstetrics and Gynaecology, Korle-Bu Teaching Hospital, Accra, Ghana, E-mail: okeezy@live.co.uk. Anthony Godi, Department of Biostatistics, School of Public Health, University of Ghana, Accra, Ghana, E-mail: tonygodi@yahoo.com.
- ABSTRACT.
- INTRODUCTION
- MATERIALS AND METHODS
- STATISTICAL ANALYSES
- RESULTS
- Sociodemographic characteristics of study participants.
- Obstetric and gynecological history.
- Maternal and fetal outcomes.
- Modified Poisson regression for maternal outcomes of elderly primigravidae compared with younger primigravidae.
- Modified Poisson regression for fetal outcomes of elderly primigravidae compared with younger primigravidae.
- DISCUSSION
- CONCLUSION
- Supplemental Materials
- ACKNOWLEDGMENTS
- REFERENCES
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Moses V, Dalal N, 2016. Pregnancy outcome in elderly primi gravidas. Int J Reprod Contracept Obstet Gynecol 5: 3731–3735.
-
2.
Laopaiboon M, Lumbiganon P, Intarut N, Mori R, Ganchimeg T, Vogel JP, Souza JP, Gülmezoglu AM; WHO Multicountry Survey on Maternal Newborn Health Research Network, 2014. Advanced maternal age and pregnancy outcomes: A multicountry assessment. BJOG 121: 49–56.
-
3.
Ghana Statistical Service, 2014. Demographic and Health Survey 2014. Accra, Ghana: Ghana Statistical Service.
-
4.
Rademaker D, Hukkelhoven CWPM, van Pampus MG, 2021. Adverse maternal and perinatal pregnancy outcomes related to very advanced maternal age in primigravida and multigravida in The Netherlands: A population-based cohort. Acta Obstet Gynecol Scand 100: 941–948.
-
5.
Nojomi M, Haghighi L, Bijari B, Rezvani L, Tabatabaee SK, 2010. Delayed childbearing: Pregnancy and maternal outcomes. Int J Reprod BioMed 8: 80–85.
-
6.
Verma S, 2009. Advanced maternal age and obstetric performance. Apollo Med 6: 258–263.
-
7.
Olusanya BO, Solanke OA, 2012. Perinatal correlates of delayed childbearing in a developing country. Arch Gynecol Obstet 285: 951–957.
-
8.
Creanga AA, Gillespie D, Karklins S, Tsui AO, 2011. Low use of contraception among poor women in Africa: An equity issue. Bull World Health Organ 89: 258–266.
-
9.
Attali E, Yogev Y, 2021. The impact of advanced maternal age on pregnancy outcome. Best Pract Res Clin Obstet Gynaecol 70: 2–9.
-
10.
Oppong SA, Torto M, Beyuo T, 2020. Risk factors and pregnancy outcome in women aged over 40 years at Korle-Bu Teaching Hospital in Accra, Ghana. Int J Gynaecol Obstet 149: 56–60.
-
11.
Odame Anto E, Owiredu WKBA, Sakyi SA, Turpin CA, Ephraim RKD, Fondjo LA, Obirikorang C, Adua E, Acheampong E, 2018. Adverse pregnancy outcomes and imbalance in angiogenic growth mediators and oxidative stress biomarkers is associated with advanced maternal age births: A prospective cohort study in Ghana. PLoS One 13: e0200581.
-
12.
Biney AAE, Nyarko P, 2017. Is a woman’s first pregnancy outcome related to her years of schooling? An assessment of women’s adolescent pregnancy outcomes and subsequent educational attainment in Ghana. Reprod Health 14: 123.
-
13.
Yussif A-S, Lassey A, Ganyaglo GY, Kantelhardt EJ, Kielstein H, 2017. The long-term effects of adolescent pregnancies in a community in Northern Ghana on subsequent pregnancies and births of the young mothers. Reprod Health 14: 178.
-
14.
Opadiran RO, Isah AD, Adewole N, Omonua KI, 2018. Pregnancy outcome in elderly primigravidae at a Nigerian Tertiary Hospital: A five-year review. Int J Reprod Contracept Obstet Gynecol 7: 391–395.
-
15.
Anozie OB, Mamah JE, Esike CU, Asiegbu OG, Lawani LO, Eze JN, Onoh RC, 2019. Pregnancy outcome among elderly primigravidae: A five-year review at Abakaliki, Ebonyi State, Nigeria. JCDR 13: QC01–QC04.
-
16.
Morris JM, Totterdell J, Bin YS, Ford JB, Roberts CL, 2018. Contribution of maternal age, medical and obstetric history to maternal and perinatal morbidity/mortality for women aged 35 or older. Aust N Z J Obstet Gynaecol 58: 91–97.
-
17.
Dixit PV, Mehendale MA, 2017. Study of pregnancy outcome in elderly gravida. Int J Reprod Contracept Obstet Gynecol 6: 5384–5389.
-
18.
Islam MM, Bakheit CS, 2015. Advanced maternal age and risks for adverse pregnancy outcomes: A population-based study in Oman. Health Care Women Int 36: 1081–1103.
-
19.
Jeong Y, Choo SP, Yun J, Kim EH, 2021. Effect of maternal age on maternal and perinatal outcomes including Cesarean delivery following induction of labor in uncomplicated elderly primigravidae. Medicine (Baltimore) 100: e27063.
-
20.
Gupta M, Saini V, 2018. Cesarean section: Mortality and morbidity. JCDR 12: QE01–QE06.
-
21.
Sobhy S et al., 2019. Maternal and perinatal mortality and complications associated with caesarean section in low-income and middle-income countries: A systematic review and meta-analysis. Lancet 393: 1973–1982.
-
22.
Sandall J et al., 2018. Short-term and long-term effects of Caesarean section on the health of women and children. Lancet 392: 1349–1357.
-
23.
Uchenna OVJ, Okwuchukwu OV, Ifunanya NJ, Idzuinya OB, Chibuzor UD-P, Nobert OC, Chukwu IC, Joy AC, 2019. Pregnancy outcome in elderly primigravidae: A 5-year review in a tertiary health care institution in Abakaliki, Southeast, Nigeria. Am J Clin Med Res 7: 44–47.
-
24.
Ben-David A, Glasser S, Schiff E, Zahav AS, Boyko V, Lerner-Geva L, 2016. Pregnancy and birth outcomes among primiparae at very advanced maternal age: At what price? Matern Child Health J 20: 833–842.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 1013 | 1013 | 127 |
| Full Text Views | 18 | 18 | 1 |
| PDF Downloads | 21 | 21 | 0 |