Behavior of perinatal mortality in pregnant women with advanced maternal age (2005-2009)

Abstract

Pregnancy at the e xtremes of reproductive life has always been a concern for those in charge of caring for expectant mothers. A cross-sectional, descriptive, retrospective study was carried out at the Mariana Grajales Obstetrics and Gynecology University Hospital in Villa Clara, from 1 January 2005 to December 31, 2009. It was aimed at characterizing the behavior of perinatal mortality in pregnant women with advanced maternal age. A non probabilistic intentional sample was taken. It was formed by the perinatal deaths in pregnant women aged 35 or older at the time of delivery. In addition, an intentional non-probabilistic sample of all perinatal deaths in pregnant women between 20 and 34 year of age was also considered as a point of reference. The following variables were taken into account: perinatal mortality, maternal age, sex of the product of conception, gestational age at delivery, birth weight, place of death, occurrence of death and cause of death. It was found that births in women aged 35 or older accounted for 13.1% of total births, with a high perinatal mortality rate ranging between 18.4 and 28.6 per thousand live births. Fetal mortality, male sex, low birth weight and prematurity predominated, with an intra-hospital and intrapartum occurrence. Concerning the cause of fetal death, 32.0% was related to placental disorders. A greater attention to preconception risk is recommended, as well as a further analysis of each fetal death in order to identify a greater number of causes.