Age at First Birth and Pregnancy Outcomes in Makurdi, Nigeria

Aims and Objectives: To determine the problems associated with primigravidae at extremes of reproductive life (less than 20 years and greater than 35 years) and compare them with those aged between 20 and 35 years.

Materials and Methods: A five year retrospective study compared 2331 primigravidae at extremes of reproductive age to an ideal age group at the Federal Medical Centre, Makurdi. Data was obtained from the Medical Records Department, Obstetric Ward and Theatre registers. Statistical analysis was performed using SPSS for windows version 16 and significance was set at a P-value of ˂ .05.

Results: Nine thousand six hundred and forty one deliveries were conducted. Out of these deliveries, there were 2,331 primiparous births (24.2%). Of the primiparous births, 137 (5.8%) were teenage mothers, 104 (4.5%) elderly primigravidae and 2090 (89.7%) were ideal age primigravidae (and also the control). The average maternal age at first birth was 25.6±3.1 years. Teenagers had their first antenatal visit later than the elderly parturients at 23 weeks and 19 weeks respectively (P < .05). The elderly primigravidae utilized antenatal services more than the teenagers and the ideal age primigravidae with booking status of 97.1% versus 62.8% and 75% respectively, while adequate antenatal attendance was 72.1% versus 21.2% and 47.0% respectively. Elderly primigravidae had a higher incidence of preterm labour, low birth weight neonates and co-existing uterine fibroids compared to the other two subgroups, which was statistically significant. The frequency of pregnancy induced hypertension and eclampsia was not statistically different for the three subgroups.

Conclusion: The number of women having their first birth at the extremes of age was small in our population. The elderly primigravidae had more unfavourable pregnancy outcomes, co-morbidities and tended to book earlier when compared with the teenagers and the ideal age group.