Nosečnost in porod po 40. letu : magistrsko delo

Menhart, Lara (author), Mivšek, Ana Polona (mentor), Vigec, Nada (co-mentor), Kvas, Andreja (reviewer)

Uvod: Nosečnost je ena izmed velikih prelomnic v življenju žensk in njihovih partnerjev in je v večini primerov srečen dogodek. Veliko nosečnosti poteka brez večjih težav, se pa lahko pri določenih ženskah pojavijo tudi razni zapleti, ki se pogosteje pojavljajo pri starejših nosečnicah. Namen: Namen magistrskega dela je bil ugotoviti, kakšne so prednosti in slabosti nosečnosti in poroda po 40. letu starosti in katere komplikacije se statistično značilno več pojavljajo pri starejših ženskah kot pri mlajših. Metode dela: Uporabili smo kvantitativne metode raziskovanja, pri čemer smo opravili sekundarno analizo podatkov, zbranih s prospektivno kohortno študijo nacionalne perinatalne baze podatkov Nacionalnega perinatalnega informacijskega sistema RS. Podatki so bili analizirani s pomočjo računalniškega statističnega programa SPSS. Rezultati: Ženske, starejše od 40 let, imajo več težav, povezanih s povečanjem družine, kot mlajše ženske. Pri starejših ženskah smo dokazali gestacijski diabetes v 20,7 % nosečnosti, pri mlajših pa v 11,2 %. Preeklampsija se je pojavila pri 4,1 % starejših žensk in 2,2 % mlajših od 40 let. Zaznali smo tudi večjo pojavnost nepravilnosti placente. Abrupcijo placente smo zasledili pri 1,3 % starejših in 0,7 % mlajših, medtem ko se je placeta previa pojavila pri 0,9 % starejših in 0,3 % mlajših žensk. Pogosteje so starejše ženske potrebovale indukcijo poroda (26,3 %) v primerjavi z mlajšimi (20,3 %) in izvedbo carskega reza, ki so ga pri starejših opravili v 43,2 % primerov v primerjavi z mlajšimi, kjer je bil porod s carskim rezom zaključen v 22,1 % primerov. Razlike smo dokazali tudi pri otrocih, saj se je starejšim ženskam rodilo 13,8 % nedonošenih otrok, mlajšim pa 7,9 %. Kot SGA je bilo rojenih 12,6 % otrok starejših žensk in 7,8 % otrok mlajših žensk. Dokazali smo statistično značilne razlike v oceni po letvici APGAR, kjer so imeli otroci starejših ženk večkrat nižje ocene tako v prvi kot peti minuti po rojstvu. Razprava in zaključek: Rezultati kažejo, da imajo ženske, starejše od 40 let, veliko več težav v nosečnosti, med porodom in po porodu kot mlajše. Več težav pa je bilo zaznati tudi pri novorojenčkih starejših mater. Pridobljeni rezultati odpirajo tudi možnost za nadaljnje raziskovanje in osveščanje žensk o tem, kako lahko višja starost vpliva na odločitev o povečanju družine.

• Language: Slovenian
• Keywords: magistrska dela, zdravstvena nega, spočetje, rojstvo otroka, poporodno obdobje, težave, višja starost matere
• Work type: Master's thesis/paper
• Typology: 2.09 - Master's Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [L. Menhart]
• Year: 2021
• Number of pages: 87 str., [2] str. pril.
• PID: 20.500.12556/RUL-134397
• UDC: 616-083
• COBISS.SI-ID: 93242115
• Publication date in RUL: 13.01.2022

Secondary language

• Language: English
• Title: Pregnancy and labour over age 40 : master thesis

Abstract

Introduction: Pregnancy is one of the biggest turning points in the life of women and their partners and in most cases a happy moment. Most pregnancies progress without major problems, however, some complications may occur in certain women. Complications are more common in advanced maternal age. Purpose: The purpose of master's thesis was to specify advantages and disadvantages of pregnancy and childbirth after the age of 40 and define which complications are statistically significant in older women. Methods: A secondary analysis of data collected through the prospective cohort study of the national perinatal database, the Perinatal Information System of the RS, was performed and quantitative research methods were used. SPSS software was used for data analysis. Results: Women over the age of 40 struggle more when trying to grow their family compared to younger women. 20.7 % of older women had gestational diabetes while that was diagnosed only in 11.2 % of younger women. Pre-eclampsia occurred in 4.15 % of older women and 2.2 % of women under the age of 40. Moreover, we observed higher incidence of placental abnormalities. Placental abruption occurred in 1.3 % and 0.7 % of older and younger women, respectively, while placenta previa occurred in 0.9 % of older and 0.3 % of younger women. Older women were more likely to require induction of labour (26.3 %) compared to the younger ones (20.3 %). In addition, caesarean section was performed in 43.2 % cases of women over the age of 40, while 22.1 % of younger women delivered with caesarean section. There were differences also in the birth of premature children. This happened in 13.8 % in older and 7.9 % in younger women. 12.6 % of children born to older and 7.8 % of children born to younger women were born as SGA. There were statistically significant differences in APGAR scores with children of older women had repeatedly lower scores, both at 1 and 5 minutes after birth. Discussion and conclusion: The results show, that women over the age of 40 are likely to have more problems during pregnancy, childbirth and during the postpartum period compared to the younger ones. More problems were also detected in newborns of older mothers. Results provide an opportunity for further research on awareness of risks of delayed childbearing among women.

• Keywords: master theses, nursing care, conception, childbirth, postpartum period, problems, advanced maternal age