Desafios Enfrentados por Mulheres Primigestas em Idade Avançada

Abstract

2 RESUMOObjetivo: Analisar a associação entre idade materna avançada e as possíveis complicações na gestação, tanto materna quanto fetal, à luz da produção científica brasileira. Material e Métodos: Trata-se de uma revisão da literatura na base de dados Biblioteca Virtual de Saúde na qual foram cruzados os descritores: complicações na gravidez e idade materna. Como critérios de inclusão para este estudo estabeleceram-se: artigos originais; estudos com abordagem qualitativa ou quantitativa; publicações escritas em português e publicadas em qualquer período. Após a aplicação destes critérios e leitura criteriosa dos artigos selecionados, restou uma amostra de seis artigos publicados entre os anos de 1998 e 2013. Resultados: A análise da amostra verificou que o casamento tardio, o maior nível de instrução feminina, e os divórcios são os principais motivos que contribuem para que a primeira gestação seja tardia. Além disso, evidenciou-se que a eclampsia e a prematuridade são os principais efeitos deletérios em primigestas de idade avançada. ABSTRACT Objective:To analyze the association between advanced maternal age and possible complications in pregnancy to the mother and the fetus in the light of the Brazilian scientific production. Material and Methods: This is a literature review based on searches carried out in the virtual library of health using combinations of the following descriptors: pregnancy complications and maternal age. The following inclusion criteria were established: original articles; studies with qualitative or quantitative approach; publications written in Portuguese and published in any time period. After applying the eligibility criteria and performing careful reading of the articles, a total of six articles published between 1998 and 2013 were included in the review. Results: The studies have shown that late marriage, higher educational level and divorce are the main reasons contributing to a delayed first pregnancy. In addition, eclampsia and prematurity were reported as the major deleterious effects in primigravida women at old age. Some results of this review were organized by approximation of content and presented in the following categories: Children? What is the right time? Reasons leading to pregnancy at old age; and deleterious effects of late pregnancy to the fetus and the mother. Conclusion: This study showed that delayed pregnancy may lead to complications that threaten the mother's and fetus' lives, including eclampsia and prematurity. Thus, a rigorous followup is essential to prevent further damage. DESCRIPTORS

Complicações na gestação em mulheres com idade maior ou igual a 35 anos

“…The women who had a comorbidity prior to pregnancy had a lower frequency of maternal complications, which is surprising since studies found that age-related diseases are determining factors for the occurrence of adverse effects in these women (5)(6) . The pregnant women who had some preexisting condition were probably in treatment and needed greater care and attention, so they were more eager to attend prenatal consultations.…”

“…This finding is explained by the gradual decline in fertility up to the age of 35 followed by a sharper decline after this age. As the age advances, the likelihood of structural defects in the ova and the frequency of chronic disease also increases, and as the age of the pregnant woman increases, the reproductive history gets progressively more complicated (5) .…”

“…This risk is the result of ovarian senility and the greater frequency of pre-existing chronic diseases, which increases with the age. Older women may be subjected to more frequent hospital admissions and are more susceptible to suffering a miscarriage, considering that 40% to 60% of these women have chromosomal alterations (5) .…”

“…A study found that women aged 35 or older are more likely to suffer adverse perinatal outcomes than younger women, especially premature birth, low birth weight, hypertension/preeclampsia, and a low Apgar score (5)(6) .…”

Estudos experimentais no período gestacional: panorama da produção científica

“…Taking into account these significant physiological and emotional changes that affect the body and mind of pregnant women, and consequently their interaction with the world, it is important that women have adequate follow-up by family and health professionals, considering that in addition to discomfort there may be many risks associated with pregnancy, leading to possible complications for both the mother and the fetus, and subsequently for the newborn (1)(2) . In this sense, it is necessary that women have access to quality and humanized prenatal care based on the best scientific evidence in order to provide timely interventions to ensure the health of the (mother-baby) binomial, thereby enabling early detection of health problems and consequently their timely treatment and avoiding complications during pregnancy and childbirth (3)(4) , thus contributing to reduced maternal mortality, which still has high occurrence.…”