Korean J Perinatol.  1999 Sep;10(3):345-352.

A Clinical Study of Nulliparous Women Aged 40 Years and Older

• Kim JY
• Kim KJ
• Son MS
• Rho GN
• Choi SH
• Choi YD

Abstract

OBJECTIVE
Our purpose was to compare the pregnancy outcomes of nulliparous women aged 40 years and older with those of nulliparous women under 35 years of age.
METHODS
From January 1989 to December 1998 total 57,563 deliveries were seen in Gachon Gil Medical Center. Among them we experienced 59 cases of nulliparas at 40 years and older. These women were compared with 188 young nulliparas under 35 years of age as the control group. The statistical analysis was performed using Chi-square tests, and statistical significance was defined as p<0.05.
RESULTS
The incidence rate of elderly nulliparas aged 40 years and older was increased from 0.04% in 1989 to 0.30% in 1998. The age distribution was from 40 years to 45 years. The gravidity of eldery nulliparas was 2.2 in comparison with 1.6 in control group. The incidence of uterine myoma, gestational DM, IUGR and oligohydramnios was significantly high rate in elderly nulliparas. There was significantly high rate of cesarean section in elderly nulliparas(88.1%) in comparison with control group(40.4%). The reasons of cesarean section were her demand(39.0%), CPD(15.3%) and breech presentation(13.6%) in decreasing order. The preterm delivery rate was 10.2% in elderly nulliparas in comparison with 4.3% in the control group. Placenta accreta and uterine atony were significantly high in elderly nulliparas and mean estimated blood loss was also high. There was no difference in 5-minute Apgar score between both group, but there were more cases of neonatal intensive care unit admission in neonates of elderly nulliparas(6.8% vs 0%).
CONCLUSION
The incidence of elderly nulliparas is continuously increasing. The elderly nulliparas and their babies are at greater risk than young women. Therefore all elderly nulliparas aged 40 years and older can be regarded as high risk patients and they must be managed with careful attention.

MeSH Terms

Age Distribution
Aged
Apgar Score
Cesarean Section
Female
Fetal Growth Retardation
Gravidity
Humans
Incidence
Infant, Newborn
Intensive Care, Neonatal
Leiomyoma
Oligohydramnios
Placenta Accreta
Pregnancy
Pregnancy Outcome
Uterine Inertia