Korean J Obstet Gynecol.  1997 Sep;40(9):1923-1935.

Meta Analysis of Elderly Gravida according to Postpartum Maternal, and Fetal and Neonatal Outcomes

• Lim S
• Lee SY

Abstract

Based on the 10 domestic theses which conducted a case-control study of elderly gra-vida over 35, meta analysis was made of the postpartum maternal outcome and fetal-neon-atal outcome with elderly gravida over 35 as cases and with gravida under 35 as controls. The findings are as follows: As for fetal-neonatal outcomes, the frequency of low birth weight was twice as high for cases , compared with controls, intrauterine growth retardation 2.4 times as high, macrosomia about 30% higher , congenital anomaly 16% higher , intrauterine fetal death 2.6 times as high, admission to newborn intensive care unit twice as high , and perinatal mortality twice as high. In case of neonatal sex , cases produced 28% more male babies than controls. As for postpartum maternal outcomes , the frequency of cesarean delivery was 2.9 times as high, compared with controls and postpartum hemorrhage 62% higher. Vaginal wall laceration, 3rd degree laceration, 4th degree laceration and cervix laceration all didn`t happen to cases as frequently as controls, while postpartum anemia was observed in cases 2.3 times as often as controls, wound infection 57% more often , bladder dysfunction 32% more , urinary tract infection 72% more and DIC about twice as often. In case of postpartum cardiomyopathy, pulmonary edema, respiratory infection, hepatitis and sepsis respectively, cases showed 7.4 times higher rate of an attack. Finally , it should be admitted that there are some problems in this study such as controversial hospital data used in analysis, the lack of clear operational definition , the lack of precise P-value, omitted standard deviation and uncontrolled confounding variables.

Keyword

Meta analysis; Elderly gravida; Postpartum maternal outcomes; Fetal-neonatal outcomes

MeSH Terms

Aged*
Anemia
Cardiomyopathies
Case-Control Studies
Cervix Uteri
Confounding Factors (Epidemiology)
Dacarbazine
Female
Fetal Death
Fetal Growth Retardation
Hepatitis
Humans
Infant, Low Birth Weight
Infant, Newborn
Intensive Care Units
Lacerations
Male
Perinatal Mortality
Postpartum Hemorrhage
Postpartum Period*
Pulmonary Edema
Sepsis
Urinary Bladder
Urinary Tract Infections
Wound Infection
Dacarbazine