Comparison of maternal and fetal outcomes in high risk age groups (adolescents and advanced ages) and reproductive age groups in our University Hospital

ABSTRACT Objective: The aim of this study is to analyze pregnancies under the age of 19 years and pregnancies above 35 years of age considered as high risk for mother and fetus and to compare the clinical features with the 19-35 year old pregnancies taken as control group at the same time evaluate the results. Materials and Methods: A total of 1164 pregnant women who applied to our hospital between January 1, 2017 and December 31, 2017 were evaluated retrospectively. The patients were divided into three groups as adolescent, repreductive and advanced age groups. Adolescent and advanced age (high risk) group pregnancies were compared with control (normal accepted reproductive age) group. The data of our study; maternal age, gravida, parity, gestational age, birth weeks, history of systemic diseases, congenital anomaly and presence of IUGR, amniotic fluid amount, type of delivery, cesarean indications, additional surgical procedures, first and fifth minute APGAR scores of newborn, birth weights, sex, mortality and morbidity data were obtained from hospital records. Statistical Package for the Social Sciences (SPSS) 15.0 for Windows (SPSS Inc. Chicago, IL, USA) was used to evaluate the data. Chi-Square analysis was used for the comparison of categorical data, and ANOVA was used for multiple comparisons, and Kruskal Wallis test was used for multiple comparison of continuous variables that did not show normal distribution. Results: A total of 1164 pregnant women were included in the study; the risky age group (adolescent and advanced age) were divided into 365 and control group 799 women. Of the women in the risk age group, 29 were adolescents and 336 were older age pregnancies. The mean age of the pregnant women was 30.82± 6.24 (14-49). The mean age of the adolescent group was 17.96±0.99 and the mean age of the elderly group was 39.17 ± 2.92. In our study, mean gravida 4.10±2.47 (1-13), mean parity 2.47±2.01(0-10), mean gestational age <34 weeks 28.60% 34-37weeks 22.16% 37-39weeks: 34.79% 39-42weeks 14.18%> 42weeks 0.26%, vaginal delivery rate; 19.16% (n: 223) cesarean birth rate; 80.84% (n: 941), rate of general anesthesia; 11.94% (n: 139), rate of spinal anesthesia; 69.07% (n: 804), newborn weight; 3.33 ± 1.05, 1. minute apgar score averages: 5.14 ± 1.98 and 5. minute apgar score averagely 7.46 ± 2.26 (0-10), IUGR patient the mean was 9.11%. 77.84% (n: 906) patient had normal amniotic fluid volume; Anhydroamnios in 8.42% (n: 98) patients; Oligohydroamnios in 8.68% (n: 101) patients; Polyhydroamnios was detected in 5.07% (n: 59) patients. In our study, the ratio of tubal ligation; 21,3% (n: 248); the rate of other additional surgical procedures was 17.18% (n: 200). When the patients were compared according to age groups, statistically significant relationship was found between parameters such as gravida, parity, mode of delivery, anesthesia, presentation, birth weight, 5th minute Apgar score, gestational age, IUGR, amniotic fluid volume, BTL, additional surgical procedures and comorbid disease. Conclusion: IUGR, preterm labor and cesarean rates were found to be high in adolescent pregnants in the risky age group. maternal mortality rates were found to be higher in pregnant women in the advanced age group with hypertensive diseases of pregnancy, GDM placental placement and invasion anomaly. Therefore, in case of detection of adolescent and advanced age pregnancies, all relevant health institutions and their employees and employees should be more cautious about making more serious antenatal follow-up and taking necessary medical measures against possible risks. Key words: Riskly age group pregnancies (adolescent and advanced age pregnancies), maternal and fetal outcomes