Author(s)

Michèle Florence Mendoua^1*, Astrid Ruth Ndolo^1,2, Henri Essome^1,2, Gertrude Moukouri^1,2, Michel Ekono^1,3, Emile Mboudou^1,4

¹Department of Surgery and Specialties, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon.
²Laquintinie Hospital of Douala, Douala, Cameroon.
³Regional Hospital Center of Ebolowa, Ebolowa, Cameroon.
⁴Gyneco-Obstetric and Pediatric Hospital of Douala, Douala, Cameroon.

Introduction: The global increase in maternal age at conception, facilitated by socio-economic advancements and assisted reproductive technologies, has led to a rise in so-called geriatric pregnancies. In resource-limited countries, this phenomenon is associated with a higher risk of obstetric and neonatal complications. This study aimed to determine the frequency and factors associated with adverse neonatal outcomes among pregnant women aged 35 and older in Douala. Methods: A prospective longitudinal observational study was conducted from January to August 2025 at the maternity ward of Laquintinie Hospital in Douala. The study included 234 pregnant women aged ≥35 years with pregnancies ≥28 weeks gestation. Sociodemographic, obstetric, and neonatal data were collected from obstetric records and analyzed using multivariate logistic regression (SPSS v.26.0). The significance level was set at p < 0.05. Results: The majority of participants were aged 35 - 40 years (67.9%), multiparous (73.9%), and without stable employment (31.6%). Adverse neonatal outcomes occurred in 34.6% of births, primarily prematurity (20.9%), intrauterine fetal death (7.3%), and neonatal asphyxia (4.7%). After adjustment, the factors independently associated with adverse neonatal outcomes were: maternal age ≥ 40 years (OR = 2.4; p = 0.012), nulliparity or grand multiparity (OR = 2.7; p = 0.008), medical history (hypertension, HIV, diabetes) (OR = 3.9; p < 0.001), previous cesarean section (OR = 2.1; p = 0.024), prenatal visits < 1/month (OR = 6.5; p < 0.001), lack of iron-folic acid supplementation (OR = 4.8; p = 0.017) and calcium (OR = 3.2; p = 0.003), intercurrent pathology during pregnancy (OR = 3.7; p < 0.001), and multiple pregnancies (OR = 5.0; p = 0.037). Conclusion: Adverse neonatal outcomes among geriatric pregnant women in Douala are common and result from both biological and contextual factors. Strengthening monthly prenatal follow-up, systematic supplementation, and early screening for comorbidities is key to reducing preventable perinatal mortality. An integrated multidisciplinary approach is essential to improve neonatal prognoses in pregnancies at advanced maternal age.

Geriatric Pregnancy, Neonatal Outcomes, Determinants, Cameroon

Mendoua, M. , Ndolo, A. , Essome, H. , Moukouri, G. , Ekono, M. and Mboudou, E. (2025) Determinants of Adverse Neonatal Outcomes among Geriatric Pregnancies in Douala (Cameroon). Open Journal of Obstetrics and Gynecology, 15, 1976-1989. doi: 10.4236/ojog.2025.1511166.