Research Article

Pregnancy and childbirth in women aged 40 and over at befelatanana maternity, Madagascar

Rakotomalala Nivoarimelina Zoly1*, Rakotozanany Besaina3, , Razafi ndraibe Andriatompoina Felanarivo3, , Ramarokoto Malalafi naritra Patrick Marco1, 2, Rafamatanantsoa Jean Florent, Kapche Wato Edith and d Randriambololona Domoina Malala Aurélia5

Published: 24 December, 2019 | Volume 3 - Issue 1 | Pages: 022-027

Objective: Pregnancy after age 40 remains a concern as it exposes to particular obstetrical complications. Our study aims to determine the risks of complications related to pregnancy and childbirth of women aged 40 and over.

Study design: We carried out a cross-sectional analytical study of a historical cohort comparing the progress and the outcome of pregnancy in women 40 years of age and over to those aged 20 and 35 who gave birth at the University Hospital of Obstetrics and Gynecology in Befelatanana, from 1st January 2010 to 31 December 2013.

Results: The prevalence of childbirth among 40 years old and over was 0.61%. They were multiparous and large multiparous in 88% of the cases. The analysis showed that parturients aged 40 years and older were at significant risk for caesarean section, with three times the risk of emergency caesarean section. The frequency of this emergency caesarean section increased with parity ((RR = 3.04 [2.15-4.30], p = 10-10). Among their neonates, 23.42% were hypotrophic, 22.86% premature, 12% asphyxiated at birth, 13.14% admitted to neonatal resuscitation and 5.71% died in utero, but without significant difference with the group unexposed. Perinatal death was 7.43% in women aged 40 and over vs. 4% in 20 to 35 year olds ((RR = 1.85 [0,89-3,86]; p 0.052).

Conclusion: We found that pregnancies after 40 years were not exposed to pregnancy-related pathologies or specific fetal complications. The use of an emergency cesarean is, however, frequent.

Read Full Article HTML DOI: 10.29328/journal.apcr.1001015 Cite this Article Read Full Article PDF


Childbirth; 40 ages; Cesarean section; Complications; Pregnancy


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