ACADEMIC AND RESEARCH PEER-REVIEWED MEDICAL JOURNALISSN 1727-2378 (Print)         ISSN 2713-2994 (Online)
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Pregnancy Outcomes in Women of Later Reproductive Age

DOI:10.31550/1727-2378-2020-19-1-12-15
For citation: Serova O.F., Sedaya L.V., Shutikova N.V. Pregnancy Outcomes in Women of Later Reproductive Age. Doctor.Ru. 2020; 19(1): 12–15. (in Russian) DOI: 10.31550/1727-2378-2020-19-1-12-15
4 February 16:40

Study Objective: to analyse specificities of pregnancy and delivery in women of later reproductive age.

Study Design: analytical retrospective study.

Materials and Methods. Labour and delivery records of women of 20–49 years old (n = 5,581) were reviewed, and primipara records (n = 2,676) were selected. These women were divided into two groups according to their age. Group I included 2,295 patients of 20–34 years old, group II comprised 384 women of 35–49 years old.

Study Results. In group II, preeclampsia was diagnosed 2.3 times more frequent than in group I: 7.0% (n = 27) vs. 3.0% (n = 69) (р < 0.05). Premature births in women of 35–49 years old were recorded 1.4 times more frequently than in women of 20–34 years old: 23.2% (n = 89) vs. 16.1% (n = 369) (p = 0.02). Women in group II had caesarean section 1.8 times as many as in group I: 76.6% (n = 294) vs. 43.1% (n = 988) (р < 0.05). Children with Apgar score of 4-6 points were 1.7 times more frequent in group II than in group I (6.8% (n = 26) vs. 3.9% (n = 89), р < 0.05), Apgar score of 1–3 points — 6 times more frequent (0.24% vs. 0.04%) (р < 0.05).

Postpartum period in patients of over 35 years old was characterised with 10-fold increase in hypotonic bleeding: 0.8% (n = 3) vs. 0.08% (n = 2) (р < 0.05).

Perinatal mortality in group II was 7.8‰, whereas in group I it was 2.0‰; still birth in group II was recorded in 6.8‰ vs. 1.6‰ in group I (р < 0.05).

Conclusion. The analysis demonstrated that primipara women of over 35 years old face higher risk of obstetrician and perinatal risks, therefore these patients should be followed up to prevent frequent gestational complications: risk of premature delivery and placental insufficiency as well as labour abnormalities.

Contribution: Serova, O.F. — study design, study aims and objectives, working hypothesis, result analysis; Sedaya, L.V. and Shutikova, N.V. — data extraction, sampling, statistical analysis, selection of cources.

Conflict of interest: The authors declare that they do not have any conflict of interests.

Received: 15.01.2020
Accepted: 27.01.2020

O.F. Serova — Moscow Regional Perinatal Centre; 12 Enthusiasts shosse, Balashikha, Moscow region, Russian Federation 143900. A.I. Burnazyan Federal Medical Biophysical Centre of the Federal Medical and Biological Agency of Russia; 12 Enthusiasts shosse, Balashikha, Moscow region, Russian Federation 143900. eLIBRARY.RU SPIN: 9837-0955. E-mail: olga-serova@yandex.ru

L.V. Sedaya (Corresponding author) — Moscow Regional Perinatal Centre; 12 Enthusiasts shosse, Balashikha, Moscow region, Russian Federation 143900. A.I. Burnazyan Federal Medical Biophysical Centre of the Federal Medical and Biological Agency of Russia; 12 Enthusiasts shosse, Balashikha, Moscow region, Russian Federation 143900. E-mail: gorda65@mail.ru

N.V. Shutikova — Moscow Regional Perinatal Centre; 12 Enthusiasts shosse, Balashikha, Moscow region, Russian Federation 143900. A.I. Burnazyan Federal Medical Biophysical Centre of the Federal Medical and Biological Agency of Russia; 12 Enthusiasts shosse, Balashikha, Moscow region, Russian Federation 143900. E-mail: shutikovanv@yandex.ru

Доктор.ру

Fig. 1. Age-specific birth rates in Moscow Region in 1986–2016 [3]

ris2_1.jpg

 

Fig. 2. Extragenital pathologies rate in pregnant women

ris2_2.jpg

 

Fig. 3. Rate of newborn asphyxia in group I and group II
* Statistically significant differences vs. group I (p < 0.05)ris2_3.jpg

4 February 16:40
LITERATURE
  1. Kulakov V.I., Serov V.N., Adamyan L.V., Abubakirova A.M. Guidelines for reproductive health. М.: Тriada-Х; 2001. 565 p. (in Russian)
  2. Djamaludinova A.F., Gonyan M.M. Reproductive health of the Russian population. Young scientist. 2017; 14.2(148): 10–13. (in Russian)
  3. Federal State Statistic Service. URL: http://www.gks.ru/ (data — 15.12.2019). (in Russian)
  4. Bayev O.R., Rumyantseva V.P., Burduli G.M., Polyanchikova O.L., Rubtsova S.V. Prognostic factors for the efficacy of mifepristone in preparation for labor. Obstetrics and Gynecology. 2011; 8: 91–4. (in Russian)
  5. Baibarina E.N., Filippov O.S., Guseva E.V. The results of development of an obstetric service in the Russian Federation and the measures for its improvement. Russian Bulletin of Obstetrician-Gynecologist; 2014; 14(4): 4–8. (in Russian)
  6. Kiseleva E.E. Social factors of women's reproductive health. Young scientist; 2015; 16: 384–6. (in Russian)
  7. Peresada O. A. Women's reproduc­tive health: a guide for doctors. M.: МIА; 2009. 678 p. (in Russian)
  8. Barinov S.V., Shamina I.V., Tirskaya Yu.I., Ralko V.V., Dudkova G.V., Frickel E.A. at al. Age-related issues of pregnancy and birth outcomes. Fundamental and Clinical Medicine. 2016; 1(2): 18–24. (in Russian)
  9. Shechtman M.M. Guide to extragenital pathology in pregnant women. М.: Тriada-Х; 2008. 816 p. (in Russian)
  10. Sitnikova, L.N., Lavlinsky L.I. The organization of medical care to pregnant high-risk groups. Bulletin of New Medical Technologies. Electronic Journal. 2014; 8(1). URL: https://naukaru.ru/ru/nauka/article/3055/view (data — 15.12.2019). (in Russian)
  11. Yudochkina I.V. Reserves for reducing perinatal morbidity and mortality in first-born older age groups: Сandidate of Sciences thesis. М.; 2008. 114 p. (in Russian)
  12. Makarov I.O., Yudina E.V. Cardiotocography during pregnancy and childbirth. M.: MEDpress-Inform; 2016. 112 p. (in Russian)
  13. Kabochkin A.A. Medico-social study of the health of pregnant women, childbirth and postpartum in a large industrial center. Сandidate of Sciences thesis. М.; 2014. 25 p. (in Russian)

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