Maternal age and pregnancy complications treatment,symptoms of pregnancy malayalam details,getting pregnant first week of pill - You Shoud Know

Maternal age at conception has long been demonstrated to have a significant correlation with pregnancy outcome and maternal health. Since a couple of decades, the world is witnessing remarkable advancements in science, literature, arts, and virtually every other field of life.
The object of this review is to assess the association between maternal age at childbearing and pregnancy outcome in light of the Pakistan Demographic and Health Survey 2006 - 20073 and other studies conducted worldwide, and thereby highlight the long term implications that the trend of increasing maternal age has for the Pakistani society. A thorough study of pertinent researches conducted worldwide and other literature available on the subject was done. In Table-1,3 the median age at first birth has been classified according to the demographics and socioeconomic status of the women. The trends in the median age of the first marriage of women,3 which is the primary indicator of maternal age at conceiving the first child, are parallel to those described above, as one would expect.
Very young (under 20 years) and old (over 35 years) women are considered 'high-risk' categories for child bearing.
According to the World Health Organization, "the perinatal period commences at 22 completed weeks (154 days) of gestation and ends seven completed days after birth."6 However, researchers have differed on the exact periods of this definition. Figure-13 presents the statistics of perinatal mortality in Pakistani women, classified according to maternal age.
The increased incidence of perinatal mortality in women aged 35 or more may be correlated to the increased probability of chromosomal errors with advancing age,7 for many genotypes that would be generated as a result may be incompatible to life.
It should be also be pointed out that this finding of mortality being inversely related to maternal age, is in fact inconsistent with other researches worldwide that have studied the relationship between these two variables.
The weight and size of children at birth are amongst the most important indicators of their health, mortality and cognitive development. Controlled studies documenting the effect of advanced maternal age on congenital anomalies in children in Pakistan could not be retrieved.
Table-23 presents pregnancy complications as a function of maternal age, and shows the most striking association.
As pointed out in the statistics of maternal age at first birth in Pakistan, the number of births that occur in the old high-risk category is a lot more than those in the very young category. As for the average Pakistani woman, at present the average median age at first birth (21.68 years)3 is well within the ideal reproductive period of a woman's life, and she is hence expected to bear many, if not most, of her children during that period, and thus may not be subject to significant repercussions of the effect of advanced maternal age. It is also noteworthy that in developed countries, volumes of research have been dedicated to determining the interplay between advanced maternal age, pregnancy outcome, and a herd of other influences. Data on the trends and attitudes of women in Pakistan concerning childbearing is essentially lacking.
Pakistan, like countries all over the world, is witnessing a trend of increasing maternal age at conception.
This journal is a member of and subscribes to the principles of the Committee on Publication Ethics. Pregnancy: respiratory ? FON p 792 box 25-6 ? Rate may increase ? 02 consumption 15%-20% greater ? Total lung capacity may be slightly decreased ? In 3 rd trimester, high fundal position may make short of breath. Prenatal care: physical exam ? Vital statistics ? Are vital signs appropriate to trimester and general health? Prenatal care: return visits ? Fetal heartbeat ? Is it within normal range for gestational age? Classically, very young (35 years) women have been classified as high-risk categories for child bearing. While on one hand, many such advancements, especially in science and technology have unquestionably created great ease for the human race, on the other, this has coerced human beings to struggle more and more to establish a career prior to marriage, in order to earn a decent living to support a spouse in raising a family. Most of the review however, is based on the findings of the Pakistan Demographic and Health Survey 2006 - 2007 (DHS),3 which is considered among the most comprehensive and reliable sources of such data in Pakistan today.
The table demonstrates that women in urban areas tend to have their first child slightly later than their rural counterparts.

Age specific fertility rates in Pakistani women belonging to the two high-risk groups are 55, and 117 respectively,3 demonstrating that more births occur in the old high-risk category.
In DHS, on which the subsequently presented data is based, it has been defined as "pregnancy losses occurring after seven completed months of gestation (stillbirths) plus deaths of live births within the first seven days of life (early neonatal deaths)".3 Thus, perinatal mortality includes foetal mortality, referring to stillbirth, and early neonatal mortality, referring to the mortality of neonates delivered live.
According to this data, while child mortality displays no clear trend, neonatal and infant mortality is roughly inversely related to maternal age, with mortality highest in mothers younger than 20 years, and gradually diminishing with higher age groups. According to the World Health Organization, low birth weight is defined as a birth weight of less than 2500 grams.11 Birth size has been classified on a three-point scale as very small, smaller than average, and average or larger.
All of the following complications depict a clear association with maternal age, younger women being less susceptible to suffer from them than their older counterparts: severe headaches, blurred vision, swelling of hands, swelling of face, high fever, fits or convulsions, continuous urine dribbling, foul smelling vaginal discharge, inability to control bowel motions, and high vaginal bleeding. Several NGOs are working in Pakistan in collaboration with the Ministry of Health, to discourage early marriages, to help decrease maternal mortality and improve pregnancy outcome. However, maternal age at first birth is considerably higher in the urban, wealthier and more educated residents, because as women become more and more empowered they chose to delay childbearing until they have achieved their career, financial and other goals. Further studies, particularly targeting the susceptible class, are required to ascertain the attitudes of would-be mothers concerning juggling their careers, jobs, and education with their traditional role in society as child bearers.
This may lead to an increasing number of infants born to mothers in the old high-risk category, which can have adverse long-term implications on the maternal and child health status of the country. Maternal mortality, fetal death, congenital anomalies and infant mortality at an advanced maternal age. Advanced maternal age and the risk of Down syndrome characterized by the meiotic stage of chromosomal error: a population-based study. Maternal age-specific rates of fetal chromosomal abnormalities at 16-20 weeks' gestation in korean pregnant women >==35 years of age.
Elevated risks of pregnancy complications and adverse outcomes with increasing maternal age.
Unwanted pregnancy and post-abortion complications in Pakistan: findings from a national study.
Factors influencing childbearing decisions and knowledge of perinatal risks among Canadian men and women. Recently, career, education, financial, and other goals have coerced women to delay childbearing all over the world. This has led to a worldwide trend of an increasing age of marriage and conception, which is particularly more marked in females.1,2 Moreover, industrialization and consequent generation of employment opportunities, along with a herd of other factors has led to an increasing number of women acquiring jobs, and hence delaying conception because of preoccupation with work outside the home. Pregnancy outcome has been considered in terms of the baby that is delivered, and its maternal consequences, that is, complications during pregnancy, delivery, and the postnatal period. Furthermore, women in Punjab and Balochistan tend to marry at a greater age, which is also consistent with the data mentioned above.
40- 49 years have a significantly greater risk of perinatal mortality, more than 50% greater than that of the 20-29 age group. This trend is most marked in neonatal mortality, with values declining from 85 in the >20 age group to 39 in the 40- 49 age group.
Statistics show that young (3 Interestingly, birth size is also a determinant of neonatal and infant mortality. Conversely, >24 hour labour and feet first delivery (footling breech) have an inverse relation, while placenta first delivery does not show any clear association.
However, this strategy is counterproductive, because if marriages are delayed, and women produce the same number of children, with the same or increased birth spacing (as is also being advocated), more children will be born in the old high risk category, which ironically deserves more concern.
Besides, in developed countries, an increasing number of research papers are being published lately, that primarily aim to assess the knowledge of women regarding the risks associated with delayed childbearing, the characteristics of women who are more unaware than others, and the factors that coerce them to delay childbearing. These studies can aid physicians in formulating effective counselling strategies for their patients.
A study of teenagers in Estonia during the period of major socio-economic changes (from 1992 to 2002).

National Down Syndrome Cytogenetic Register and the Association of Clinical Cytogeneticists.
This trend is also becoming apparent in Pakistan, especially in the upper middle class, wealthy and educated women, as they become increasingly empowered.
Often married females choose to practice contraception to prevent the troubles and complications of pregnancy and delivery from interfering with their professional careers, until their careers become well settled.2 This trend is also becoming discernible in Pakistan, especially in urban areas, where the new generation of the upper and middle socioeconomic class is becoming increasingly career-oriented. A discussion on the relevance of the topic at hand to our society has been presented at the end.
It is also noteworthy, that on average, women had their first child 2.7 years after their marriage.
Similarly mothers in the 30- 39 age group are at greater risk than the group preceding them.
This leads to the inference that children born to younger mothers are at a greater risk, whereas those born to older mothers are not at much risk. Hence, an overwhelming majority of these problems are associated with advanced maternal age. Hence, while on one hand it may help overcome the complications of the very young high-risk category, it may pose a greater challenge to NGOs, the Ministry of Health and various other stakeholders to deal with the escalated old high-risk category. Children who are delivered safely are many at times left at garbage dumps at the outskirts of cities, in sanitary drains or in 'jhoolas' (baby cradles) set up at the network of Edhi Centers across the country.
Physicians catering to these classes must counsel their clients on the possible risks associated with delayed childbearing in terms of its effects on the health on the mother and her child. One such study, published in the Canadian journal of public health, (2006), entitled "What do women know about the risks of delayed childbearing?" sought two of the aforementioned aims. This will in turn help avert the long-term repercussions that the trend of increasing maternal age may have, if left unchecked.
This review presents the association between maternal age and pregnancy outcome, particularly in the context of statistics of Pakistan, and its possible repercussions. Furthermore, in the vast majority of categories, older women (40 -45 years) had their first child at a younger age than those of the youngest category, which corroborates the finding present above. However, it seems that mortality is not independently related to maternal age, but is the product of the interplay of other factors also.
Also noteworthy is the fact that, as pointed out in the statistics and discussion above, congenital anomalies, pregnancy complications, and complications during delivery, and the post natal period are only associated with the old category, and bear no association to young high risk women, so it is the former that is worthy of greater concern. On one hand, physicians need to develop effective counseling strategies for their patients in this regard, and on the other, more studies are required to ascertain the attitudes of Pakistani women, particularly those belonging to the upper and middle classes, regarding delayed childbearing, that can aid physicians in formulating effective counseling strategies.
For example, older women have already delivered more children before, so because of their multiparity, their subsequent children are at a lesser risk of mortality. Similarly, parents and grandparents should be counselled to get their children married as soon as they (their children) are financially and socially fit to do so.
Hence, it is probable that if this factor was controlled, that is, if two groups of younger and older mothers were each giving birth to their first child, child mortality would be the same in both groups, or younger mothers may be at a greater advantage.
Even though, apparently, many obstetricians in the setup of our current hospitals do counsel patients on the ideal reproductive age, it is uncertain as to how appealing and effective it is. Community Medicine and Behavioural Sciences curricula of undergraduate medical education also need to be re-devised to include such counselling.

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