Adverse Obstetrical and Perinatal Outcomes Among Advanced Age Pregnant Mothers in Northeast Ethiopia: A Comparative Cross-Sectional Study

Ukba Asefa,1 Wolde Melese Ayele2 1Department of Gynecology and Obstetrics, Dessie Specialized Referral Hospital, Dessie, Amhara Regional State, Ethiopia; 2Department of Epidemiology and Biostatistics, Wollo University, Dessie, Amhara Regional State, EthiopiaCorrespondence: Wolde Melese AyeleDepartment of Epidemiology and Biostatistics, Wollo University, Dessie 1145, EthiopiaTel +251921885231Email wolde400@gmail.comPurpose: It is known that being pregnant at any reproductive age is not risk-free. Aside from this, older gravidity usually ends up with adverse outcomes both to the mother and newborn. Hence, the aim of this study was to investigate the association of adverse maternal and perinatal outcomes with advanced maternal age pregnancy in Northeastern Ethiopia.Methods: A hospital-based comparative cross-sectional study was employed among pregnant mothers. The study was conducted among advanced age (≥ 35 years, n= 398) mothers and adult age (20– 34 years, n=398) mothers. Socio-demographic, obstetrics, and pregnancy outcomes were checked from patient records. Descriptive statistics were used to describe parameters collected from patient records and comparing the two groups. Bivariable and multivariable logistic regressions were done to determine factors associated with maternal and perinatal outcomes. The magnitude of the association was measured using odds ratio at 95% confidence level and statistical significance was declared at a P-value of < 0.05.Results: Advanced age mothers had significantly higher adverse pregnancy outcomes (64.6% vs 37.8%) compared with adult age mothers. This study shows that advanced maternal age is statistically associated with pregnancy-induced hypertension (AOR=3.14, 95% CI: 1.931– 5.089), antepartum hemorrhage (AOR=2.22, 95% CI: 1.245– 3.942), a cesarean delivery (AOR=2.59, 95% CI: 1.775– 3.790), and postpartum hemorrhage (AOR=2.01, 95% CI: 1.445– 2.819). Moreover, advanced maternal age pregnancy was also a risk factor for preterm delivery (AOR=3.01, 95% CI: 1.441– 6.297), low birth weight (AOR=3.08, 95% CI: 1.735– 5.492), low fifth minute Apgar score (AOR=3.99, 95% CI: 2.099– 7.618), and perinatal death (AOR= 2.46, 95% CI: 1.360– 4.42).Conclusion: In this study, adverse pregnancy and perinatal outcomes among advanced aged mothers were high in a specialized hospital where emergency obstetric and newborn care is set and quality obstetric care is expected. Therefore, healthcare providers, the specialized hospital, and policymakers should give due emphasis to the effective intervention of advanced age pregnant mothers.Keywords: advanced maternal age, pregnancy, adverse obstetric outcome, adverse perinatal outcomes, Ethiopia