Pregnancy after 40 years of age.

Using a 1982-4 computerized data base from a perinatal network, 511 pregnancies in women whose age was 40 or more years at delivery were studied. The oldest woman was 52 years of age. This represented 1.2% of the 41,335 women delivering. Their pregnancy outcomes were compared with those in 26,759 whose age at delivery was 20 to 30 years. The older women were more parous and had higher weights. There was also an increased frequency of hypertension, diabetes mellitus, and placenta previa in the older women. These changes had a significant impact on the fetus for the older women had an increase in infant macrosomia, male sex, stillbirths, and low Apgar scores. They also had a higher incidence of cesarean section and fewer forcep deliveries. The older women whose weight was less than 67.5 kg at delivery did not show any difference in hypertension, fetal macrosomia, fetal death rates, or low infant Apgar scores. Also older of low parity did not have an increase in placenta previa. The older women of normal weight and low parity showed a higher frequency of diabetes mellitus and cesarean section delivery, but their infant outcomes were not different from the control groups. Thus older women of low parity and normal weight managed by modern obstetric methods can expect a good pregnancy outcome.