الفهرس 
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Abstract
Advanced maternal age is defined as an age of mother who is 35 years or more at the time of delivery, it has become increasingly common in last two to three decades. In the developed world, the changing pattern of becoming pregnant at an advanced age can be attributed to various reasons. The reason could be changes in the structure of family with more late marriages or remarriages, women’s pursuit of higher education, carrier advancement, advances in assisted reproductive technique and availability of effective and safe contraceptives. But in the developing countries, the scenario is different. The women tend to become pregnant at advanced age due to concept of having large family size, sometimes the desire for male child and moreover due to lack of knowledge about the availability of effective contraception (Smithson et al., 2022).
Delayed childbearing is believed to be associated with an increased rate of obstetrical and perinatal complications, as well as adverse pregnancy outcomes. When compared to younger women, women in the advanced maternal age are reported to be at greater risk of congenital disorders, placenta previa, ectopic pregnancy, spontaneous abortion, stillbirth, preterm birth, induction of labour and caesarean delivery. Also, the prevalence of chronic medical conditions (e.g., diabetes mellitus, hypertension) and other diseases with a possible influence on a course of pregnancy (such as cancer) which are higher among older patients. Multiple studies suggest that the incidence rate of perinatal complications only begins to increase after the age of 35years old. (Radoń-Pokracka et al.,2019).
Aim of the Study:
This study aims to assess care given to prevent complications among the advanced pregnant maternal age through:
1) Assessing health problems of advanced maternal age pregnant women
2) Assessing health needs of advanced maternal age pregnant women
3) Assessing women’ knowledge and self-practices to prevent complications of advanced maternal age pregnant women
Research questions:
1. What is care given to prevent complications among advanced maternal age pregnant women?
2. What are health problems of advanced maternal age pregnant women?
3. What are health needs of advanced maternal age pregnant women?
4. Is there a relation between advanced maternal age pregnancy and occurrence of complications?
5. Is there a relation between advanced maternal age pregnant women’ knowledge and their self-practice to prevent complications?
Research design:
A descriptive design was utilized to achieve the aim of this study.
Research setting:
The study was conducted at the obstetrics and gynecology clinic of Sayed Galal University Hospital which affiliated to Al Azhar University as it is a university hospital and serves a large number of patients, so it is expected to meet a large number of pregnant women at the advanced age.
Subjects:
A purposive sample of 365 pregnant women who were attended at the previously mentioned setting were involved in this study.
Data collection tools:
Data were collected through the use of the following 3 tools.
Tool I: A Structured Interviewing Questionnaire sheet that was developed by the researcher after reviewing the relevant literature and was written in a simple Arabic language .
It was divided in to five parts:
• Part I: The socio demographic characteristics of the advanced maternal age pregnant women such, as (age, marital status, level of education, occupation, place of residence, monthly income, number of children and number of rooms in the house. It included questions from 1-9.
• Part II: It included the past and present medical history of the advanced maternal age pregnant women It included questions 10.
• Part III: It included the past and present obstetrical history of the advanced maternal age pregnant women. The past history involved the gravidity, parity, and any complications during pregnancy while the present history involved the last menstrual period, expected delivery date, gestational age, and any complain during pregnancy. It included questions from 11-19.
• Part IV: It included the health needs and health problems of the advanced maternal age pregnant women (Sharifi, et al., 2020)
- Health Needs included early and regular follow up, modify daily life, reduce work pressure, rest, treat food by reducing the salt, high protein food, obesity control, change eating habit, calcium tablet and practice regular exercise. It included questions from 20-30.
- Health Problems included bleeding, headache gestational diabetes, pregnancy-induced hypertension, vaginal infections, urinary tract infections, constipation, muscles spasm of the legs, swelling of the extremities, problems of the teeth and gums and others. It included question 31.
• Part V: it included knowledge of the pregnant women about complications of the advanced maternal age pregnancy (El-Nagar, et al., 2017). Included:
The complications of pregnancy at the advanced age for the mother as well as for the fetus. It included questions from 32-33.
Tool II: Self-Reported Practices:
Reported practice of pregnant women regarding care given to prevent complications among the advanced pregnant maternal age (El-Nagar, et al., 2017). Included:
• Follow up during pregnancy included following pregnancy and number of times went to follow up. It included questions 34 and 35.
• Personal care included take a shower, massage breast, brush teeth and consult a doctor when dental problem occur. It included questions from 36 – 39.
• Proper nutrition included eating healthy food, adequate amount of food, water, juices, fruits, and taking vitamins. It included questions from 40 – 44.
• Exercise included doing exercise and the kind of sport that practice. It included questions 45 and 46.
Tool III: Prenatal Follow- up Sheet: Care given to advanced maternal pregnant women such as:
• Physical Examination included the first date of the last period, expected delivery date, number of weeks of pregnancy, mother’s weight, and blood pressure. It included questions from 47 – 51.
• Laboratory Examination included blood group, complete blood picture, glucose analysis, urine analysis for protein and Rh factor. It included questions from 52 – 56.
• Medical Examination included heart, lungs, urinary system, breasts, thyroid gland, swollen legs and dental examination. It included questions from 57 – 63.
Results of the present study revealed that:
Regarding personal characteristics of the study sample, the current study result showed that, more than two thirds of them were in age group more than 35 and less than 40 and more than half of them are working.
Regarding health problems of advanced maternal age pregnant women, the current study result showed that more than half of the study sample had no problem.