The older obstetric patient

As societal norms have changed over the years, so has the timing of childbearing for many women, particularly those who delay childbearing to achieve their educational and career aspirations. In addition, there are those who conceive late with the help of assisted reproduction techniques, including ovum donation. Much of the literature shows that there are increased maternal and fetal risks with increasing maternal age. Complications of early pregnancy include ectopic pregnancy, miscarriage, and chromosomal abnormality. Maternal morbidity includes complications of hypertensive diseases and diabetes. Caesarean section rates are higher. Maternal mortality overall is higher for older women; they are over-represented in deaths from pulmonary embolism, hypertensive disease, amniotic fluid embolism, and psychiatric causes of maternal death. The weight of data continues to support the view that increasing maternal age is a significant risk factor when assessing pregnancy and perinatal outcome.