Epidemiological And Chronological Profile Of The Parturientes In The Extreme Ages In The Monastir Region Between 1994 And 2003

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Kamel Ben Salem
Sana El Mhamdi
Imen Ben Amor
Asma Sriha
Mondher Letaief
Mohamed Soussi Soltani

Abstract

Background : Pregnancy outside 19 - 34 years interval is risk factors of the maternal and fetal morbidity and mortality. Tunisia, witch known an epidemiological transition, implanted the national program of perinatality since 1990 and one of its objectives is the surveillance of the high risk pregnancies.
Aim : The aim of this study is to draw up the epidemiological profile of the parturient in extreme ages in the region of Monastir and to study the chronological tendencies of the associated factors during a decade (1994 - 2003).
Method: In all, the study interest 13225 extreme ages parturient, representing 22.5% of all women admitted for delivery in the public maternities of the district.
Results: The means age was 18.6 ± 0.6 years for the parturient less than 20 years and 37±2 years for the older than 35 years and more, among them 40% were older primipara. The prenatal care was inadequate for 35.4% of younger women and 47.6% of aged women.
During the decade, we notice a significant decrease of the frequency of pregnancy for teenager parturient (from 3 in 1994 to 1.99% in 2003), and increase for the aged parturient (from 14.7 in 1994 to 17.7% in 2003) (p<0.001). Adequate prenatal care increased and the frequency of parturient without any follow-up decreased (from 17.2 to 2%) (p<0.001).
Conclusion: Given to this demographic and social transition, our healthcare system is called for greater vigilance and a more rigorous application of the recommendations of the national program of perinatality.

Keywords:

Maternal age, prenatal care, chronology, Tunisia

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References

  1. Treffers PE. Teenage pregnancy, a worldwide problem. Ned Tijdschr Geneeskd 2003; 22:2320-5.
  2. Montan S. Increased risk in the elderly parturient. Curr Opin Obstet Gynecol 2007; 19:110-2.
  3. Heffner LJ, Elkin E, Fretts RC. Impact of labor induction, gestational age and maternal age on cesarean delivery rates. Obstet.Gynecol 2003; 102:287-293.
  4. Tabcharoen C, Pinjaroen S, Suwanrath C, Krisanapan O. Pregnancy outcome after age 40 and risk of low birth weight. J Obstet Gynaecol 2009; 29:378-83.
  5. Ozalp S, Mete TH, Sener T, Yazan S, Keskin AE. Health risks for early ² 19 and late ? 35 year childbearing. Arch Gynecol Obstet 2003; 268: 172-174.
  6. Huang L, Sauve R, Birkett N, Fergusson D, van Walraven C. Maternal age and risk of stillbirth: a systematic review. CMAJ 2008; 178:165-72.
  7. Kumar A, Singh T, Basu S, Pandey S, Bhargava V. Outcome of teenage pregnancy. Indian J Pediatr 2007; 74:927-31.
  8. Ministère de la Santé Publique. Office National de la famille et de l'enfant. Enquête sur la santé et le bien être de la mère et de l'enfant (Multiple Indicator Cluster Survey) 2008.
  9. Ickovics JR, Kershaw TS, Westdahl C, Magriples U, Massey Z, Reynolds H et al. Group prenatal care and perinatal outcomes: a randomized controlled trial. Obstet Gynecol. 2007; 110:330-9.
  10. Zhu BP, Haines KM, Le T, McGrath-Miller K, Boulton ML. Effect of the interval between pregnancies on perinatal out-comes among white and black women. Am J Obstet Gynecol 2001; 185:1403-10.
  11. Williams EK, Hossain MB, Sharma RK, Kumar V, Pandey CM, Baqui AH. Birth interval and risk of stillbirth or neonatal death: findings from rural north India. J Trop Pediatr 2008; 54:321-7.
  12. Smith GC, Pell JP, Dobbie R. Interpregnancy interval and risk of preterm birth and neonatal death: retrospective cohort study. BMJ 2003; 327:313-18.
  13. Niedhammer I, O'Mahony D, Daly S, Morrison JJ, Kelleher CC. Occupational predictors of pregnancy outcomes in Irish working women in the Lifeways cohort. BJOG 2009; 116:943-52.
  14. Covarrubias LO, Aguirre GE, Chapuz JR, May AI, Velázquez JD,Eguiluz ME. Maternal factors associated to prematurity. Ginecol Obstet Mex 2008; 76:526-36
  15. Santos GH, Martins Mda G, Sousa Mda S, Batalha Sde J. Impact of maternal age on perinatal outcomes and mode of delivery. Rev Bras Ginecol Obstet 2009; 31:326-34.
  16. Naqvi MM, Naseem A. Obstetrical risks in the older primigravida. J Coll Physicians Surg Pak 2004; 14:278-81.
  17. Schoen C, Rosen T. Maternal and perinatal risks for women over 44--a review. Maturitas 2009; 64:109-13.
  18. Wojcicki JM, Hessol NA, Heyman MB, Fuentes-Afflick E. Risk factors for macrosomia in infants born to Latina women. J Perinatol 2008; 28:743-9.
  19. Sanhua VM, Juárez CM, Moreno Mdel C, Posada EG, Horwitz MK, Ramos RV et al. Relation among pathological maternal history and weight diagnosis at birth. Ginecol Obstet Mex 2004; 72:561-9.
  20. Mehra S, Agrawal D. Adolescent health determinants for pregnancy and child health outcomes among the urban poor. Indian Pediatr 2004; 41:137-45.
  21. Njah M, Hellali J, Tabka A, Souissi M, Marzouki M. Facteurs déterminants du choix du lieu d'accouchement et place des maternités périphériques en milieu semi-urbain Tunisien. Rev. Français. Gynecol. Obstet 1995; 90:148-154.
  22. Haws RA, Yakoob MY, Soomro T, Menezes EV, Darmstadt GL, Bhutta ZA. Reducing stillbirths: screening and monitoring during pregnancy and labour. BMC Pregnancy Childbirth 2009;9 (Suppl 1) :S5.