TITLE:
Determinants of Adverse Maternal Outcomes among Advanced Age Pregnant Women in Douala (Cameroon)
AUTHORS:
Michèle Florence Mendoua, Astrid Ruth Ndolo, Henri Essome, Gertrude Moukouri, Michel Ekono, Emile Mboudou
KEYWORDS:
Advanced Maternal Age, Maternal Complications, Cesarean Section, Pregnancy Pathologies, Calcium, Douala
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.15 No.11,
November
25,
2025
ABSTRACT: Introduction: Advanced maternal age is an increasing obstetric risk factor, particularly in African contexts where demographic transition is accompanied by delayed motherhood. This study aimed to identify the determinants of adverse maternal outcomes among older pregnant women in Douala. Methodology: This was an observational longitudinal analytical study with prospective data collection, conducted at Laquintinie Hospital in Douala from January to August 2025. It included 234 women aged ≥35 years who gave birth from 28 weeks of gestation onward. Sociodemographic, obstetric, medical, and prenatal data were collected through patient interviews, prenatal care booklets, and the hospital’s maternity obstetric records. Statistical analysis involved χ2 tests and multivariate logistic regression to identify factors independently associated with adverse maternal outcomes. The significance level was set at p Results: The frequency of adverse maternal outcomes was 20.5%, including 9.8% postpartum hemorrhages, 4.7% preeclampsia/eclampsia, and 3.4% maternal deaths. The main factors independently associated with adverse outcomes were: • Age ≥ 40 years (OR = 2.31 (1.12 - 4.76); p = 0.023), • Low education level (OR = 2.10 (1.01 - 6.83); p = 0.047), • Unemployment (OR = 1.94 (1.01 - 3.74); p = 0.048), • Medical history (OR = 2.08 (1.01 - 4.31); p = 0.044) and previous cesarean section (OR = 2.12 (1.03 - 4.36); p = 0.039), • Pathology discovered during pregnancy, particularly gestational hypertension (OR = 2.87 (1.22 - 6.75); p = 0.015). Regular calcium supplementation was identified as a significant protective factor against adverse maternal outcomes (OR = 0.42 (0.20 - 0.90); p = 0.024). Conclusion: Adverse maternal outcomes remain common among women of advanced maternal age in Douala, primarily linked to age ≥ 40 years, medical history, and precarious socio-economic conditions. These findings highlight the importance of integrating calcium supplementation into routine antenatal care. And targeted monitoring of at-risk women, is essential to reduce maternal morbidity and mortality in this group.