| Abstract | Odgoda rađanja predstavlja najznačajniju promjenu reproduktivnog ponašanja u posljednjih nekoliko desetljeća. Kako se društveni trendovi pomiču prema starijoj dobi žena pri prvom porodu, postaje sve važnije razumjeti rizike povezane s takvim trudnoćama. Cilj rada bila je analiza perinatalnih ishoda žena životne dobi ≥44 godine (N=25) te usporedba s perinatalnim ishodom kod mlađih žena (N=25). Istraživanje je provedeno u Klinici za ženske bolesti i porode Kliničkog bolničkog centra Zagreb u razdoblju od 1. siječnja do 31. prosinca 2023. godine. Analizirana je životna dob trudnica, postojanje preegzistentnih bolesti, reprodukcijska anamneza komplikacije u trudnoći (gestacijski dijabetes melitus, preeklampsija, placenta previa..) i porodu (carski rez, postporođajno krvarenje) te komplikacije novorođenčeta (prematuritet, porođajna masa, Apgar-zbroj, prijem u Jedinicu intenzivnog liječenja..). Statistička analiza provedena pomoću SPSS-a primjenom Fisherovog egzaktnog testa te t-testa za neovisne uzroke uz statističku značajnost p ≤0,05. U promatranom razdoblju rođeno je ukupno 2898 živorođene djece, od kojih je 0.88% bilo novorođenčadi majki životne dobi ≥ 44 godine. Te su trudnice imale više komorbiditeta i značajno češće su imale trudnoće iz medicinski pomognute oplodnje (p=0,0036), Starija skupina trudnica imala je veći broj komplikacija u trudnoći, prosječno kraće trajanje gestacije i češći carski rez, dok je u novorođenčadi promatrane skupine porođajna masa bila značajno niža u usporedbi s mlađim trudnicama. Rezultati ovog istraživanja pokazali su da je starija životna dob majke povezana s povećanim rizikom za razvoj komplikacija u trudnoći, češćim prijevremenim porođajem, operativnim dovršenjem trudnoće i nižom porođajnom težinom novorođenčadi. U trudnica starije životne dobi često prisutni komorbiditeti dodatno opterećuju perinatalni ishod. Trudnoće i porođaji u ovoj skupini trudnica najčešće su urednog ishoda ukoliko su vođeni u centrima tercijarne razine skrbi. |
| Abstract (english) | The postponement of childbirth represents the most significant change in reproductive behaviour in recent decades. As societal trends shift towards older maternal age at the birth of the first child. understanding the risks associated with such pregnancies becomes increasingly important. The aim of this study to analyse perinatal outcomes in women aged ≥ 44 years (N=25) and to compare these outcomes with those of younger women (N=25). The study was conducted at the Clinic for Obstetrics and Gynecology of the Clinical Hospital Center Zagreb from January 1 to December 31, 2023.. The study examined maternal age, the presence of pre-existing conditions, reproductive history, pregnancy complications (such as gestational diabetes mellitus, preeclampsia, placenta previa), delivery complications (such as cesarean section, postpartum hemorrhage), and neonatal complications (such as prematurity, birth weight, Apgar score, and admission to the Neonatal Intensive Care Unit). Statistical analysis was performed using SPSS, applying Fisher's exact test and t-test for independent samples with statistical significance set at p ≤0.05. During the observation period, a total of 2,898 live births were recorded, of which 0.88% were infants born to mothers aged ≥44 years. These pregnant women had more comorbidities and significantly more often had pregnancies resulting from medically assisted reproduction (p=0.0036). The older group of pregnant women experienced a higher number of pregnancy complications, had a shorter average gestation and a higher frequency of cesarean sections. In the neonates of this group, birth weight was significantly lower compared to those born to younger mothers. The results of this study demonstrated that advanced maternal age is associated with an increased risk of pregnancy complications, higher rates of preterm birth, operative delivery, and lower neonatal birth weight. The frequently present comorbidities in older pregnant women further burden perinatal outcomes. However, pregnancies and deliveries in this group result in favorable outcomes when managed in tertiary care centers. |
