Author(s)

Samaké Alou^1*, Diarra Lasseny², Keita Mamadou¹, Haidara Dramane¹, Haidara Mamadou³, Diallo Mamadou¹, Konaté Moussa¹, Maiga Mariam¹, Mohamed Saydi Ag Med Elmehdi Elansari¹, Kassogue Djibril⁴, Seydou Zana Dao⁵, Samake Hawa⁶, Konate Karim², Dembele Bertin², Coulibaly Moussa⁷, Mariko Seydou⁸, Collarete Dohino⁷

¹Reference Health Center of Commune VI of the Bamako District, Bamako, Mali.
²Bamako Dermatology Hospital (BDH), Bamako, Mali.
³Kalaban Coro Reference Health Center, Bamako, Mali.
⁴Timbuktu Hospital, Timbuktu, Mali.
⁵Reference Health Center of Commune II of the Bamako District, Bamako, Mali.
⁶Reference Health Center in Commune V of the Bamako District, Bamako, Mali.
⁷National Institute for Training in Health Sciences, Bamako, Mali.
⁸Mali Hospital, Bamako, Mali.

Introduction: Late pregnancies are considered a public health problem linked to maternal mortality due to their complications. These risks, which worsen with maternal age, should be better known and taken into account in monitoring these pregnancies. Objective: To evaluate the impact of age on the prevalence of obstetric and neonatal complications among parturients of 40 years old and over. Methodology: This was an 11-year retrospective analytical case control study from January 1, 2007 to December 31, 2017. The study population was female patients of 40 years old or older for cases and female patients younger than 40 years of control case. Results: In total, we collected 640 cases of parturients of 40 years old and over out of a total of 84,234 deliveries during the study period; i.e. a frequency of 0.76%. Spontaneous abortion increased in patients of 40 and over with 8.28%. Hypertension and diabetes were higher of women of 40 and over, 52.65%. Concerning the method of admission: 55% of parturients of 40 and over were referrals. Incidents occurring among women of 40 and over were more pronounced than in control cases. Complications during vaginal delivery, cervical tear, perineal tear, uterine dehiscence and uterine rupture are high in our cases, i.e. 11.88%; 3.59%; 2.19%; 2.66. During our study, depending on the type of delivery, the cesarean rate was much higher among women of 40 and over than among control cases, i.e. 54.22% versus 12.24%. Hemorrhages in the 3rd trimester were the main indications for cesarean section. Hemorrhages in the 3rd trimester were more frequent with women of 40 and over, i.e. 10.47%; 5.94% versus 1.74% and 0.42%. As for the different types of malformations in parturients, women under 40 years old fetal malformations were absent in 92.29%, on the other hand they were more frequent in patients with 40 years and over, i.e. a normal frequency of 36.72%. Conclusion: Pregnancy at a late age exposes the elderly patient and the newborn to several risks. During this study, an increase in maternal-fetal morbidity was observed with aged women.

Advanced Maternal Age, Childbirth, Risk, Mali

Alou, S. , Lasseny, D. , Mamadou, K. , Dramane, H. , Mamadou, H. , Mamadou, D. , Moussa, K. , Mariam, M. , Elansari, M. , Djibril, K. , Dao, S. , Hawa, S. , Karim, K. , Bertin, D. , Moussa, C. , Seydou, M. and Dohino, C. (2024) Maternal Fetal Prognosis: Pregnancy and Delivery in Women of 40 Years Old and Over in a Second Reference Hospital in Bamako. Open Journal of Obstetrics and Gynecology, 14, 509-519. doi: 10.4236/ojog.2024.144044.