A prospective, comparative study of 360 pregnant women with their first physiological pregnancy was conducted. The women were divided into two groups: 180 women aged 22-28 and 180 women aged 36-42. The study aimed to compare the course of pregnancy, frequency of complications, structure of drug therapy, and outcomes of childbirth among somatically healthy women from different age groups. It was found that older women had a statistically significant increase in the incidence of gestational diabetes mellitus (17.2% versus 5.0%), pre-eclampsia (13.9% versus 3.9%), and fetoplacental insufficiency (26.1% versus 8.9%). Additionally, a higher need for medical support was revealed. Progesterone preparations were prescribed to 54.4% of women in the older group compared to 23.3% in the younger group. Antiplatelet agents were also used more frequently in the older group (37.2%) than in the younger group (13.9%). Cesarean delivery rates were higher among the older women, with 44.4% in the older group versus 22.8% in the younger comparison group. The indicators of newborn condition also varied: the Apgar score at 5 minutes <8 points was recorded in 11.7% of babies born to older mothers, compared with 3.3% in the control group. These findings confirm the need for differentiated approaches to managing pregnancies in older women. Despite the increased risks associated with older age, modern obstetric techniques allow for successful management and favorable perinatal outcomes when adequate medical care is provided.
