Pregnancy outcome in medically complicated and uncomplicated patients aged 40 years or older.

Patients (183) who were delivered at age greater than or equal to 40 years were studied to ascertain the nature and frequency of maternal and fetal complications at a single institution in a recent time period. These patients were further grouped into those of low parity, those who began pregnancy without underlying disease, and those who began pregnancy with underlying medical disorders. For the entire group preeclampsia, premature labor, precipitate labor, and malpresentation were significantly more common. The rate of vaginal delivery was substantially decreased, and serious postpartum morbidity was relatively common. The incidence of stillbirth, perinatal mortality, and abnormal birth weight was significantly increased. There were some differences in the nature and frequency of complications encountered among the subgroups, but no subgroup had a complication rate comparable to our general obstetric population.