High delivery intervention rates in nulliparous women over age 35

Objective: To assess the effect of maternal age and parity on obstetric interventions and pregnancy outcome. Study design: A retrospective review of 35 140 deliveries including 4268 parturients aged 35 years or more (1985–1992). Obstetrical interventions and outcome were analyzed in relation to age and parity. Results: Nulliparous women aged 35 years or more had a 2-fold increase in cesarean delivery rate over younger nulliparae, and 50% more cesarean deliveries than the multiparae aged 35 years or more. Similar trends were observed in preterm labor, labor induction, breech presentation, and instrumental delivery. Higher risk was encountered in neonatal 1 min Apgar scores < 3, and in admissions to the neonatal intensive care unit. There were no differences in all parameters between women over age 40 and women aged 35–40 years. The perinatal mortality was not increased and was similar in all groups. Conclusions: Nulliparae aged more than 35 years are at increased risk for interventions and cesarean sections. However, women aged 35–40 have a similar risk as women aged over 40 years.