Original ArticlesChildbearing beyond age 40: pregnancy outcome in 24,032 cases
Section snippets
Materials and methods
A newly created unique database was used that linked maternal and neonatal/infant hospital discharge records to birth and death certificate records. The linkage of vital statistics data was established for all civilian hospitals that report to the California Office of Statewide Health Planning and Development during 1992–1993. This database did not include deliveries in military facilities, home deliveries, out-of-state deliveries, and deliveries at birthing centers not reporting to the
Results
The entire population of patients whose discharge information was available and who delivered during the period of the study included approximately 1,160,000 women. There were 24,032 patients in the study population age 40 or older (nulliparas, 4777; multiparas, 19,255), representing 2.1% of the total population. The control population (age 20–29) was composed of 642,525 patients (nulliparas, 258,900; multiparas, 383,625), or 55% of the entire population. In Figure 1, the age distribution of
Discussion
This study shows that first-time mothers who are giving birth at age 40 or older are at high risk for some form of operative delivery (our findings: cesarean delivery, 47.0%; operative vaginal delivery, 14.2%), compared with younger nulliparous women (cesarean delivery, 22.5%; operative vaginal delivery, 12.9%). The multiparous women in our study who were age 40 or older had significant increases in rates of operative deliveries (cesarean delivery, 29.6%; operative vaginal delivery, 6.3%)
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