Pregnancy outcome in extremes of reproductive age at a tertiary care hospital

Abstract

INTRODUCTION: Pregnancy outcomes in teenagers and in elderly are independently associated with adverse outcomes. The aim of this study was to find out pregnancy outcome at extremes of reproductive age. METHODS: This was a retrospective cohort study conducted between April 2010 and October 2013 at a tertiary care hospital. Individual pregnancy records, delivery suite register and neonatal care unit records were traced in order to gather information. Mortality data were traced from respective units and cross checked with hospital monthly perinatal statistics. Outcome data were compared between teenage pregnancies and pregnancies at normal age (20-34). Same comparison was done for mothers with advanced maternal age. RESULTS: A total of 12477 pregnancies were included (teenage-1009, normal-10192, advanced maternal age-1276). Intra-uterine death (IUD) rate and early neonatal death rates were not significantly higher among teenagers compared to age group 20-34 (OR 0.57, 95% CI 0.17 to 1.83 and OR 2.53, 95% CI 0.71 to 8.97 respectively). Preterm birth rate was significantly high among teenagers (OR 1.33, 95%, CI 1.12 to 1.56). In mothers with advanced age, early neonatal death rate and caesarean section rate were significantly higher than the age group of 20-34 (OR 3.33 95% CI 1.17 to 9.49 and OR 2.17 95% CI 1.92 to 2.44 respectively). In contrast, caesarean section rate was low in teens (OR 0.44 95% CI 0.36 to 0.52). Stillbirth and preterm birth rates were not significantly different (OR 1.36 95% CI 0.66 to 2.76 and OR 0.98 95% CI 0.83 to 1.15) in mothers with advanced maternal age. CONCLUSIONS: Risks of pregnancy complications are different from teens and in advanced maternal age. More studies are needed to establish the exact causes of these risks and evaluate management options in these women.