Abstract
Background: Women who are 35 years of age or older at the anticipated date of delivery are considered to have advanced maternal age (AMA). This cutoff age was chosen in light of decreasing fertility data and growing concerns about the increased likelihood of genetic defects in the progeny of pregnant women over 35. An increased risk of perinatal deaths, spontaneous abortions, pregnancy complications like diabetes mellitus (DM) and hypertension (HTN), interventions like cesarean deliveries (CS), and foetal adverse events like preterm birth (PTB), low birth weights (LBW), congenital anomalies, and NICU admission is linked to older mothers. 
Objective: Evaluation of the impact of advanced maternal age on maternal, obstetric, fetal, and perinatal outcomes was the main objective of the study.
Patients and methods: This study was a prospective cohort study at the Obstetrics and Gynecology Department at Mansoura University Hospitals. This study was conducted on a total of 82 primigravida women who were divided into 2 groups. The study group included 41 women aged 35 years or more. The control group included 41 women aged 20 years to 34 years. 
Results: there was a significant difference between both groups about cesarean (CS) deliveries, preterm birth, high mean arterial pressure, and high Rate Pressure Product. 
Conclusion:  advanced maternal age is accompanied by a higher rate of preterm birth, cesarean delivery, high mean arterial pressure, and rate pressure product more than younger age women.