Pregnancy outcome in elderly primigravidae with and without a history of infertility.

The pregnancy outcome of 196 primigravidae aged 35 years or over, with no history of involuntary infertility, was compared with that of 196 matched primigravidae aged 20-25 years, and also with 72 'elderly' primigravidae (greater than or equal to 35 years) whose pregnancies had followed a period of involuntary infertility of at least 1 year. The older primigravidae with no history of infertility had a four-fold risk of preterm (less than 37 weeks) delivery, a five-fold risk of caesarean section and significantly increased rates of vaginal operative delivery, chronic hypertension and fibroids, when compared with the primigravidae between 20 and 25 years of age. They also showed a greater tendency to severe preeclampsia and perinatal death, but these differences were not statistically significant. Elective caesarean section was twice as common in the older women with a history of infertility than in those without such a history (20.8% compared with 10.7%) although this difference was not statistically significant. No other differences in pregnancy outcome were found between the two 'elderly' groups.