Obstetric Outcome of Advanced Maternal Age in Women Presenting to a Tertiary Care Hospital

Abstract

Advanced maternal age (AMA), commonly defined as pregnancy at 35 years or older, is associated with increased maternal and perinatal complications. Women of advanced age are at higher risk of obstetric comorbidities such as gestational diabetes mellitus and pre-eclampsia, which may influence delivery outcomes, particularly the rate of caesarean section. Objective: To determine obstetric outcomes in women of advanced maternal age presenting to a tertiary care hospital. Methods: This cross-sectional study included 69 women aged 35–50 years with singleton pregnancies. Women with multiple gestations, previous caesarean section, immune disorders, and known fetal chromosomal abnormalities (microdeletions or aneuploidies) were excluded. Data were collected on maternal comorbidities, including gestational diabetes mellitus, pre-eclampsia, anaemia, and fetal distress. Obstetric outcome was assessed in terms of mode of delivery, particularly caesarean section. Data analysis was performed using SPSS version 25. Associations were evaluated using appropriate statistical tests, with a p-value <0.05 considered statistically significant. Results: The mean maternal age was 43.67 ± 3.92 years, and the mean body mass index was 25.9 ± 1.1 kg/m². Gestational diabetes mellitus was present in 29.0% of patients, while 20.3% developed pre-eclampsia. Caesarean section was performed in 43.5% of cases. A statistically significant association was observed between caesarean delivery and the presence of gestational diabetes and pre-eclampsia (p < 0.05). Conclusion: Advanced maternal age was associated with a high rate of caesarean section (43.5%). The likelihood of operative delivery was significantly increased in women with gestational diabetes mellitus and pre-eclampsia. Enhanced antenatal surveillance and early identification of high-risk conditions may improve obstetric outcomes in this population.