Study of the relationship between advanced maternal age and the best gestational age for the resolution of low-risk pregnancies in a public maternity hospital in São Paulo

Abstract

The number of women of advanced maternal age has increased dramatically and it is known that this leads to an increase in morbidity and mortality for women and newborns, with a significant impact on the mother-baby binomial and on the health system. Objective: to evaluate and describe, retrospectively, advanced maternal age (AMA) associated with gestational age (GA) as a risk factor for neonatal complications in a public hospital in São Paulo. Method: retrospective cross-sectional observational study on neonatal outcomes in pregnant women with AMA stratified as low risk, comparing such neonatal outcomes through the Apgar score at 1 and 5 minutes in those between 40 weeks and 40 weeks and 6 days and in those ≥41 weeks in the last five years, from January 1, 2019 to December 31, 2023, with vaginal deliveries. Data were collected from a survey of data described in an Excel spreadsheet with information collected directly from the electronic medical records of patients treated by the service. Results: during the period evaluated, 269 women were eligible to participate in the study. Of these, 202 patients had GA between 40 weeks and 40 weeks and 6 days and 66 patients had GA ≥41 weeks. The mean Apgar scores at the 1st and 5th minutes of the two groups under analysis were compared. In Group 1, the mean Apgar score at the 1st minute was 8.67 and that at the 5th minute was 9.25. In Group 2, the mean Apgar score at the 1st minute was 8.55 and that at the 5th minute was 9.33. The dispersion of Apgar scores at the 1st and 5th minute was observed in the two groups analyzed, with a concentration of scores above 7 in all GAs, both in the 1st minute and in the 5th minute Apgar. The Pearson correlation coefficient was evaluated between the variables: Apgar at the 1st minute and at the 5th minute and gestational age, with the coefficient for Apgar at the 1st minute being 0.036754 and at the 5th minute being 0.072099. Finally, the difference in the means of the two groups was analyzed based on the Student’s t-test, whose confidence level is 95% and p equal to 0.05. The p-value for the means of Apgar 1 of groups 1 and 2 is 0.128. The p-value for the means of Apgar 5 of groups 1 and 2 is 0.214. Conclusion: when comparing the average Apgar scores at the 1st and 5th minute between these groups, no relevant statistical differences were observed and, therefore, there is no correlation between the variables studied.