ASSOCIATION BETWEEN MATERNAL AGE AND

ADVERSE PREGNANCY OUTCOMES: A

COMPARATIVE STUDY AMONG MOTHERS
DELIVERING IN KERICHO COUNTY HOSPITAL
NAME: KIPYEGON WILLY

REG NO: HE15/40007/14

SUPERVISOR: Madam Esther Nyaboga

DATE: 12/07/2018 1
Introduction
Maternal age has recently gone up worldwide and particularly in
developed countries
Maternal age of 35 years or more is regarded as advance
maternal age
Statistics by the Centers for Disease Control (CDC) have it that
over the last few decades, the mean age that most of the women
give birth to the first child had surprisingly gone up.
Birth rate of women under 30 and under 20 years are decreasing.

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Cont’d
Maternal age has long been associated with a number of adverse
pregnancy outcomes.
Globally, over 20 million children, (15.5%) of total global births, are
delivered with low birth weight and studies hints association with age of
the mother
Several studies have linked age above 35 years with increased risk of
stillbirth
Risk of preterm birth with the age is a little confusing based on the past
studies. Some studies links it with age while others do not see any
association
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Problem Statement
Advance maternal age and adverse occurrence of pregnancies is a global
concern
A short inquiry into the matter prompted a need to have a deep inquiry in
the matter at Kericho County Hospital.
The facts recorded in the maternal record’s book showed increasing cases of
adverse pregnancy outcomes in the past few years.
Still birth increased by 5% from 23 % to 28% during 2015 to 2016
Miscarriage increased by 7% from 46% in 2014 to 55% in 2016.
Since what is not exclusively known cannot be controlled, this study sought
to unravel the real situation in Kericho County and give recommendations to
the facility and stakeholders to take the much needed charge.

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Broad Objective
To assess the association between maternal age and adverse
pregnancy outcomes among mothers who gave birth in Kericho
County Hospital.
Specific Objectives
i. To assess the Demographic Characteristics of mothers giving birth
in Kericho County Hospital
ii. To examine the occurrence of Adverse Pregnancy Outcomes in
mothers of younger age giving birth in Kericho County Hospital
iii. To assess the occurrence of Adverse Pregnancy Outcomes in
mothers of old age giving birth in Kericho County Hospital
iv. Compare pregnancy outcomes between mothers aged below 35 years
and those aged above 35 years giving birth at Kericho County
Hospital.
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Research Questions
i. What are the Demographic Characteristics of mothers giving
birth in Kericho County Hospital?
ii. What are the occurrence of Adverse Pregnancy Outcomes in
mothers of younger age giving birth in Kericho Hospital?
iii. What are the occurrence of Adverse Pregnancy Outcomes in
mothers of old age giving birth in Kericho County Hospital?
iv. How can the pregnancy outcomes of mothers aged below 35
years and those aged above 35 years giving birth at Kericho
County Hospital be compared?

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Conceptual Framework
1.12: Conceptual Framework
DEPENDENT VARIABLES:

INDEPENDENT VARIABLE: - Pregnancy outcomes

- Stillbirth
- Maternal Age - Miscarriage
o ˂35 years - Birth Weight
o ˃35 years - Caesarian
Delivery
- Preterm Birth

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Research Methodology
Research Design
This was a quantitative study. Descriptive cross sectional
design was used.
A retrospective cohort study approach was used since as it
looked at data that already exists.
5- year period data from records was sort out from the
Hospital Maternity Records covering January, 2013 to
December, 2017.
Upon collection and sorting, outcomes were modeled into
two groups in relation to maternal age.
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Sampling

Fisher et al., (1998) formula was used to calculate the

sample size and it produced 359. (calculation in document
page x)

Random sampling method was adapted.

359 records were included in the research using a ratio to

have an equal yearly distribution based on the number of
births in each of the 5 years.

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Table showing calculation of the ratios in the five years
under study
Year No. of records Number used (sample size)

2013 922 63

2014 1097 75

2015 1401 96

2016 1062 73

2017 758 52

TOTAL 5236 359

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Findings
Socio-demographic factors
Age;
 Below the age of 35 were 217 making 60.4%
 Above the age of 35 were 142 making 39.6%.
Marital status;
 Married were 258, making 71.9%,
 Widowed were 24, making 6.7%
 Single were 77, 21.4%.
Education;
 With primary school were 43, (12%)
 With secondary school education were 205, making 57.1%.
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Cont’d
Education;
Those with university and college education were 97, 27%
Those with no formal education were 14, 3.9%
Occupation;
 Those employed accounted for 31.8% (114)
 Farmers were 149 (41.5%),
 Business-women were 38 (10.6%)
 Students were 58 (16.2%).
Religion;
 Christians were 351 accounting 97.8%
 Muslims were 8 accounting 2.2%.
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RISK OF ADVERSE PREGNANCY OUTCOMES WITH AGE
OF THE MOTHER

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Occurrence of Adverse Pregnancy Outcomes below 35 years
Pregnancy Outcomes
Normal Caesaria Low
Newbor Stillbirt n Miscarria Preterm Birth
  n h Delivery ge Birth Weight Total
Age of the  
respondents
74 1 36 47 20 39 217
(<35 Years)

               

Occurrence of Adverse Pregnancy Outcomes in mothers above 35

years Pregnancy Outcomes Total
Normal Caesaria
Newbor Stillbirt n Miscarria Preterm Low Birth  
  n h Delivery ge Birth Weight  
Age of the  
respondents
>35 Years 36 2 17 40 14 33 142  

                

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Interpretation of Relative Risk
The relative risk is calculated by dividing the incidence rate of cases in
the unexposed group (women below the age of 35) from the incidence
rate in the exposed (women above the age of 35)
1 means there is no association while a figure less than 1 shows a
negative association/protective effect.
1.1 - 1.3 shows a weak association
1.3 – 1.7 - modest association
1.8 – 3.0 - moderate association
3 – 8 - strong association
8 – 16 - very strong
16 – 40 - dramatic association
40+ - overwhelming association
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Findings
 There is a strong association between age of the mother and risk of
stillbirth, with a relative risk of 3.05.
 There is a modest association between advance age and risk of miscarriage
with a relative risk of 1.3.
 There is weak association between the age and risk of low birth weight
with a relative risk of 1.29
 The relative risk of Caesarian Delivery with age is 0.72 and hence the risk
of miscarriage decreases with advancing age
 There is no association between age of the mother and the risk of preterm
birth. The relative risk is 1.07

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Conclusion
Generally speaking, there is an increase in the risk of
adverse pregnancy outcomes with advancing age especially
stillbirth. However the findings on analysis may have been
affected due to unequal size in the two populations used.
Could’ve been considered during sampling
This work has added essential information on this subject
which is seemingly is poorly researched particularly in
Kericho County, Kenya.
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Recommendations
With this findings from Kericho County Hospital, it is reccommended that
the hospital would embark on a serious enlightenment program and reach
out to all the clients visiting the hospital. This will enable the women to
make informed choices on matters pregnancy and childbearing. They can
also pay special attention to mothers who are above 35 years e.g., more check
up and visits and monitoring during pregnancy and delivery
Advancement in maternal age should not be a reason to avoid getting
pregnant although it pose a lot of risk to both the mother and the unborn.
Instead, there should be close supervision of the expectant mother by the
practitioners/health care workers.
The study recommends enlightenment of women to stop delaying marriages
and consequently delaying pregnancies and child bearing. Can this be the
solution?
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Limitations
The findings of this study can only be generalized to similar settings.
The findings on analysis may have been affected due to unequal size
in the two populations used. Could’ve been considered during
sampling, you can explain why this was not possible if asked

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References
Huang L, Sauve R, Birkett N, Fergusson D, van Walraven C. (2008) Maternal
age and risk of stillbirth: a systematic review.CMAJ. 15; 178(2):165-72. doi:
10.1503/cmaj.070150. Review. PMID: 18195290
Jolly M, Sebire N, Harris J, et al. (2000) the risks associated with pregnancy
in women aged 35 years or older. Hum Reprod 2000;15:2433-7.
Joseph KS, Allen A, Dodds L, et al. (2005) The perinatal effects of delayed
childbearing. Obstet Gynecol 2005; 105:1410-8.
Richardson, S., Thomson, A., Best, N., & Elliott, P. (2004). Interpreting
posterior relative risk estimates in disease-mapping studies. Environmental
Health Perspectives, 112(9), 1016.
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THANK YOU

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