FETAL OUTCOMES IN ELDERLY PRIMIGRAVIDA PATIENTS PRESENTING TO A TERTIARY CARE HOSPITAL
DOI:
https://doi.org/10.71000/8f7s1473Keywords:
Apgar Score, Infant, Premature, Pregnancy Outcome, Primigravida, Stillbirth, Tertiary Care Centers, Women, AgedAbstract
Background: The global trend toward delayed childbearing has resulted in a growing number of women experiencing their first pregnancy at an advanced maternal age. Elderly primigravida, defined as women aged 35 years or older at first conception, are considered a high-risk obstetric group due to age-related physiological changes and increased susceptibility to pregnancy complications. Despite this rising prevalence, locally relevant data on fetal outcomes in elderly primigravida remain limited. Generating context-specific evidence is essential to guide antenatal counseling, risk stratification, and perinatal care in tertiary healthcare settings.
Objective: To determine the frequency and pattern of adverse fetal outcomes among elderly primigravida women presenting to a tertiary care hospital.
Methods: A descriptive study was conducted in the Department of Obstetrics and Gynecology, Saidu Group of Teaching Hospital, from 03 September 2024 to 02 March 2025. Pregnant women aged 35–45 years with a gestational age greater than 20 weeks and primigravid status were enrolled using consecutive non-probability sampling. Participants were followed until delivery. Fetal outcomes assessed included preterm birth, stillbirth, neonatal intensive care unit (NICU) admission, and low Apgar score at five minutes. Demographic and clinical data were recorded, and statistical analysis was performed using IBM SPSS version 25.
Results: A total of 221 elderly primigravida women were included. The mean maternal age was 40.04 ± 2.81 years, mean gestational age was 35.52 ± 4.65 weeks, and mean body mass index was 23.98 ± 2.64 kg/m². Most participants were aged 40 years or below (60.6%), and 54.3% delivered at or before 36 weeks of gestation. Prematurity was the most frequent fetal outcome, observed in 40.3% of cases, followed by NICU admission in 29.9%, low Apgar score in 24.9%, and stillbirth in 20.4% of pregnancies.
Conclusion: Elderly primigravida pregnancies were associated with a substantial burden of adverse fetal outcomes, with prematurity being the most common. These findings highlight the need for vigilant antenatal surveillance and optimized perinatal care to improve fetal outcomes in this growing obstetric population.
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