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Clinical and Experimental Obstetrics & Gynecology  2020, Vol. 47 Issue (2): 243-247    DOI: 10.31083/j.ceog.2020.02.5173
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Difference in pregnancy outcomes between primiparous and multiparous women older than 40 years
S. Y. Jung1, *, S. J. Chon1, R. S. Lee1, E. Y. Woo1, J. S. Lee1, S. Y. Kim1
1Department of Obstetrics and Gynecology, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
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Abstract  Purpose of Investigation: This study aimed to compare pregnancy outcomes based on parity in women older than 40 years. Materials and Methods: This retrospective cohort study included women older than 40 years with singleton pregnancy, who delivered after 24 weeks of gestation. They were divided into two groups on the basis of parity, and maternal and perinatal outcomes were compared. Results: This study included 432 women, with primiparous women (n=111) comprising a quarter among them. The mean parity of multiparous women was 1.8, and the mean interval from the previous pregnancy was 9.5 years. On analyzing multivariable logistic regression-adjusted confounding factors, small for gestational age (SGA) neonates (OR, 2.525; 95% CI, 11.407-4.529) were associated with primiparous women. The occurrence of preterm birth before 37 weeks of gestation (OR, 1.783; 95% confidence CI, 1.080-2.942) was increased in multiparous women. Conclusion: There are different pregnancy outcomes between primiparous and multiparous women. Preterm birth is more frequent in multiparous women, with an extremely long interval to subsequent pregnancy. The incidence of SGA newborns was higher among primiparous women.
Key words:  Maternal and perinatal outcomes      Parity      Small for gestational age (SGA)     
Published:  15 April 2020     
*Corresponding Author(s):  S. Y. Jung   
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S. Y. Jung, S. J. Chon, R. S. Lee, E. Y. Woo, J. S. Lee, S. Y. Kim. Difference in pregnancy outcomes between primiparous and multiparous women older than 40 years. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(2): 243-247.

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https://ceog.imrpress.com/EN/10.31083/j.ceog.2020.02.5173     OR     https://ceog.imrpress.com/EN/Y2020/V47/I2/243

Table 1  — Maternal clinical characteristics.
Total (n=432) Primiparity (n=111) Multiparas (N=321) p-value
Maternal age 41.5±1.7 41.2±1.6 41.6±1.7 0.076
Parity 1.8±0.8 <0.001
Body mass index 23.4±4.2 23.0±3.7 23.6±4.4 0.164
Marriage status 415 (96.1%) 109 (98.2%) 306 (95.3%) 0.259
Smoking 6 (1.4%) 0 6 (1.9%) 0.345
Assisted conception 13 (3.0%) 7 (6.3%) 6 (1.9%) 0.046
Interdelivery interval 9.5±5.6 <0.001
Prenatal care 410 (94.9%) 108 (97.3%) 302 (94.1%) 0.184
Preterm birth history 31 (9.7%) 0.001
Table 2  — Comparison of pregnancy outcomes.
Total (N=432) Primiparity (n=111) Multiparity (n=321) p-value
Gestational age at delivery 36.6±3.2 37.3±2.6 36.4±3.4 0.003
Preterm birth <37 weeks of gestation 152 (35.2%) 28(25.2%) 124 (38.6%) 0.011
Major fetal anomaly 11 (2.5%) 3 (2.7%) 8 (2.5%) 1.000
Intrauterine fetal death 6 (1.4%) 2 (1.8%) 4 (1.2%) 0.650
No maternal disease 302 (69.9%) 80 (72.1%) 222 (69.2%) 0.564
Maternal disease 130 (30.1%) 31 (27.9%) 99 (30.8%)
Preexisting hypertension 13 (3.0%) 5 (4.5%) 8 (2.5%) 0.333
Preeclampsia 59 (13.7%) 13 (11.7%) 46 (14.3%) 0.489
Pregestational diabetes mellitus 11 (2.5%) 3 (2.7%) 8 (2.5%) 1.000
Gestational diabetes mellitus 44 (10.2%) 14 (12.6%) 30 (9.3%) 0.327
Placenta previa 44 (10.2%) 11 (9.9%) 33 (10.3%) 0.911
Cesarean section 307 (71.1%) 84 (75.7%) 223 (69.5%) 0.214
Before labor 295 (96.1%) 79 (94.0%) 216 (96.9%) 0.320
In labor 12 (3.9%) 5 (6.0%) 7 (3.1%)
Neonatal sex (M) 233 (54.2%) 59 (53.2%) 174 (54.4%) 0.824
Birth weight 2789.9±781.2 2810.2±721.4 2782.9±782.0 0.743
Small for gestational age 68 (15.8%) 26 (23.4%) 42 (13.1%) 0.010
Large for gestational age 14 (3.2%) 5 (4.5%) 9 (2.8%) 0.365
Apgar score <7 at 5 min 18 (4.2%) 3 (2.7%) 15 (4.7%) 0.581
No postpartum complication 393 (91.0%) 104 (93.7%) 289 (90.0%) 0.246
Postpartum complication 39 (9.0%) 7 (6.3%) 32 (10.0%)
Transfusion 28 (6.5%) 6 (5.4%) 22 (6.9%) 0.593
Cardiovascular morbidity 5 (1.2%) 0 5 (1.6%) 0.334
Urogenital morbidity 3 (0.7%) 0 3 (0.9%) 0.573
Others 3 (0.7%) 1 (0.9%) 2 (0.6%) 1.000
Table 3  — Multivariate logistic regression analysis of pregnancy outcomes in primiparous women compared with multiparous women.
Pregnancy outcome Primiparity Multiparity
aOR1 (95% CI) aOR1 (95% CI)
Assisted conception 4.228 (1.285-13.906) 0.239 (0.073-0.787)
Small for gestational age 2.525 (1.407-4.529) 0.405 (0.226-0.726)
Fetal major anomaly 0.896 (0.2023-3.959) 1.125 (0.256-4.934)
No maternal disease 1.037 (0.613-1.757) 0.937 (0.554-1.584)
Intrauterine fetal death 3.851 (0.467-31.767) 0.272 (0.033-2.234)
Preterm birth <37 weeks of gestation 0.535 (0.322-0.887) 1.783 (1.080-2.942)
No postpartum complication 1.415 (0.562-3.565) 0.689 (0.274-1.732)
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