Pregnancy outcome in elderly primigravidae at the University of Maiduguri Teaching Hospital, Maiduguri, Nigeria

Maternal age is an important determinant of pregnancy outcome and women aged 35 years and above undergoing their first pregnancy are often classified as high risk obstetric patients. The objective of this study was to determine the birth outcome in some women going through their first pregnancy at 35 years and above compared with their younger counter parts aged 20-34 years. A ten year retrospective casecontrol study of the birth outcome of elderly primigravidae compared with younger primigravidae (20-34 years) managed at the University of Maiduguri teaching hospital, Maiduguri, Nigeria. During the study period, there were 24,085 deliveries out of which 102 were elderly primigravidae giving the incidence of 0.42%. The elderly primigravidae are more prone to pregnancy induced hypertension and Preeclampsia (x 2 =9.41, p=0.002) and caesarean section (x 2 =30.26, p=0.0001) compared to the younger mother. However, the incidences of post date pregnancy and failed induction of labour (FIOL) were found to be much higher in the control than the elderly primigravidae with p values of 0.001 and 0.024 respectively. There was no statistically significant difference in the incidence of miscarriages, premature rupture of membranes (PROM), placental abruption, preterm labour/contractions, instrumental vaginal deliveries and fetal outcome in the two groups. Elderly primigravidae are at an increased risk of pregnancy induced hypertension and Preeclampsia as well as caesarean delivery than the younger primigravidae. However the fetal outcomes are comparable. We recommend modification of social habits to reduce the occurrence of elderly primigravida.