Pregnancy and delivery outcome in young and older primigravidae

Abstract

Cilj istraživanja: Utvrditi i usporediti ishod trudnoće i poroda na početku i pri kraju reproduktivne dobi. Materijal i metode: U istraživanje je uključeno 59 prvorotkinja mlađih od 18 godina i 233 prvorotkinje starije od 35 godina, koje su rodile u našoj ustanovi tijekom dvogodišnjeg razdoblja (od 2006. do 2007. god.). Podaci su prikupljeni retrospektivno, pretraživanjem medicinske dokumentacije i rađaoničkog protokola hospitaliziranih rodilja. Rezultati: U starih prvorotkinja značajno je povećan broj medicinskih zahvata u trudnoći kao i učestalost komplikacija u trudnoći (36,48% vs. 16,94%, p<0,05). U starih prvorotkinja značajno je češća i učestalost operativnog dovršenja poroda carskim rezom (23,60% vs. 8,47%, p<0,05) iako nije uočena značajna razlika u nepravilnostima rađanja. Mlade prvorotkinje znatno češće rađaju uz epiduralnu analgeziju (32,20% vs. 25,32%, p<0,01). Ne postoji značajna razlika u trajanju gestacije, u srednjoj vrijednosti rodne mase, niti razlika u Apgar score novorođenčadi. Zaključak: Mlade i stare prvorotkinje su rizične skupine rodilja koje zahtijevaju posebnu opstetričku skrb i planiranje načina rađanja. Negativan učinak životne dobi na ishod trudnoće jače je izražen u starijih prvorotkinjaAim: Tto determine and compare the frequency of the risk of pregnancy and delivery outcome at the beginning and ending of reproductive age. Methods: The study included 59 nulliparous adolescents younger than 18 years and 233 nulliparous women 35 years and older in the period of two years (2006-2007). Birth records and patient files were retrospectively analised and compared. Results: In the primiparae of 35 years or more, medical interventions during pregnancy were higher, and the risk of chronic diseases which complicated their pregnancies increased (36,48% vs. 16,94, p<0,05). The incidence of cesarean section was statistically higher in pregnancies above 35 years (32,20% vs. 25,32 % p<0,01). Birth weight, APGAR scores and, incidence of premature birth, were not significantly different between groups. Conclusion: Both adolescents and women of advanced reproductive age comprise distinct groups of obstetrics patients. Each has special needs and is susceptible to different obstetric risks. Nulliparous women of 35 years and older have higher risk of negative effect of age on their pregnancies