Epidemiology and clinical outcomes of advanced maternal age: a cross-sectional study at Saint-Joseph Hospital and the University Clinics of Kinshasa in the Democratic Republic of Congo.

Abstract

Introduction: advanced maternal age is defined as women aged 35 years or older at the estimated date of delivery based on the woman's physiology. Pregnancies at this maternal age are at risk for adverse obstetric outcomes. The objective of this study is to determine the epidemiological and clinical profile of elderly mothers at Saint-Joseph Hospital and the University Clinics of Kinshasa in the Democratic Republic of Congo.

Methods: this is a cross-sectional study of a series of records of elderly mothers who were followed and gave birth in the maternity wards of Saint-Joseph Hospital and the University Clinics of Kinshasa from January 1, 2018, to December 31, 2022, using non-probability convenience sampling for case selection. Descriptive analyses were performed in the statistical analyses.

Results: the birth rate among advanced mothers was 28.7% with their average age of 38.65 (SD: 2.64) years, housewives, married mothers and those with university education were present respectively in 62.78%, 95% and 49.75% of cases, their average parity was 3.69 (SD: 1.96) deliveries and primiparous mothers were present in 43.2% of cases. The spontaneous abortion´s history was present in 43.2% of cases, scarred uterus history in 29.61% of cases, pregnancy-induced hypertension´s history in 6.1%, and pre-eclampsia´s history in 2.53% of cases. The advanced maternal age was significantly associated with the occurrence of pre-eclampsia (aOR: 3.5, 95% CI: 1.3-9.5, p=0.002), pregnancy-induced hypertension (aOR: 2.3, 95% CI: 1.7-7.8, p=0.012), prematurity (aOR: 2.7, 95% CI: 1.4-5.0, p=0.001), low birth weight (aOR: 2.5, 95% CI: 1.1-63, p=0.002) and admission to neonatal unit (aOR: 2.5, 95% CI: 1.0-6.3, p=0.020).

Conclusion: the pregnancy in mothers with advanced maternal age is a real public health problem, primiparas with university education, married women, and housewives with a history of spontaneous abortion and scarred uterus are more affected. Adverse obstetric outcomes include preeclampsia, pregnancy-induced hypertension, prematurity, low birth weight, and admission to the neonatal unit.