Management of the elderly primigravida

Obstetrics and Gynecology (Impact Factor: 5.18). 11/1956; 8(4):494-9.
Source: PubMed
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    Canadian Medical Association journal 03/1959; 80(3):163-5. · 5.81 Impact Factor
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    ABSTRACT: More and more women in the United States are choosing to delay motherhood until their 30s or even 40s. Yet traditional medical advice warns against midlife pregnancy, predicting a variety of adverse reproductive outcomes associated with “advanced maternal age.” Assignment to a high-risk category may result in heightened feelings of concern about pregnancy complications among midlife mothers. Because it is possible that increased emotionality during pregnancy may itself give rise to various childbearing complications, some middle-aged women may become victims of iatrogenic stress during pregnancy. This article first examines critically the medical literature describing the relationship between maternal age and pregnancy outcomes and finds little support for the medical pessimism. Next, the article describes the literature that explores the links between heightened emotionality during pregnancy and various negative outcomes and suggests that, despite serious methodological flaws, there is some evidence that fear-induced stress during pregnancy may place certain middle-aged women at higher risk for complications. Finally, strategies for improved decisionmaking and for enhancing the pregnancy experience of midlife women are proposed.
    Psychology of Women Quarterly 12/1988; 12(4):445-460. DOI:10.1111/j.1471-6402.1988.tb00977.x · 2.12 Impact Factor
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    ABSTRACT: Women over the age of 30-35 are presumed to encounter more adverse pregnancy outcomes because of their reduced reproductive efficiency. In the vast majority of studies of advanced maternal age and pregnancy outcome, however, researchers have failed to control for important contextual differences surrounding the pregnancy and childbirth experiences of younger and older women. These contextual differences can account for a considerable portion of the differential results mistakenly ascribed to reproductive age. In this article are reviewed research findings that identify three such hidden factors: older women's increasing likelihood of chronic diseases that adversely affect pregnancy outcome; the altered medical management of middle-aged women's pregnancies and labors, with resultant iatrogenically caused complications; and demographic characteristics suggesting that midlife pregnancy in the past has been associated with poverty or subfertility and today is associated with healthy middle-class postponers.
    Health Care For Women International 02/1989; 10(4):395-415. DOI:10.1080/07399338909515863 · 0.63 Impact Factor
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