Publication:

Maternal and perinatal outcomes associated with advanced maternal age in an urban tertiary hospital in Nigeria: a prospective cohort study

Background Advanced maternal age (AMA) is increasingly common worldwide and is associated with heightened maternal and perinatal risks. However, evidence from low- and middle-income countries, including Nigeria, remains limited. This study assessed the association between advanced maternal age and selected maternal and perinatal outcomes in an urban Nigerian tertiary hospital.

Methods This was a prospective cohort study conducted at the Department of Obstetrics and Gynaecology, Lagos State University Teaching Hospital, Ikeja. Pregnant women with singleton gestations who booked for antenatal care in the first trimester were consecutively recruited and followed until delivery. Participants were categorized into advanced maternal age (≥35 years) and normal maternal age (<35 years). Data on socio-demographic characteristics, obstetric history, and maternal and perinatal outcomes were collected using a standardized questionnaire. Statistical analysis was performed using statistical package for the social sciences (SPSS) version 26. Associations were assessed using Chi-square tests and logistic regression, with statistical significance set at p<0.05.

Results A total of 119 women were enrolled, of whom 45 (37.8%) were of advanced maternal age. Women in the AMA group were predominantly multiparous (70.3%), compared with an equal distribution of primiparous and multiparous women in the normal maternal age group (p=0.047). Advanced maternal age was strongly associated with mode of delivery, with significantly higher caesarean section rates among AMA women (77.8% versus 43.7%; p<0.001). Although not statistically significant, clinically relevant trends were observed in the AMA group, including higher rates of obesity and preterm delivery. Increasing maternal age was associated with higher odds of pregnancy-related diagnoses, though this did not reach statistical significance.

Conclusion Advanced maternal age in this cohort was strongly associated with multiparity and a markedly increased likelihood of caesarean delivery.