Later Age Pregnancy
It is no longer unusual for women to wait until they are in their late 30s or early 40s to have their first child. With all the advances in medical care and technology, it is safer today than ever before for most women in later age to become pregnant. There are still some increased risks associated with later-age pregnancy that you should know if you fit into this category.
How Can I Prepare?
Here are some things you can do to decrease the likelihood of complications:
- Educate yourself about the increased risk of genetic disorders (chromosome abnormalities) and tests you may consider having during pregnancy to detect them.
- Make sure any existing medical condition (e.g., high blood pressure, diabetes, thyroid disease, obesity) is in a stable, controlled state before considering pregnancy. Discuss pregnancy with your doctor and how it might affect your current medical condition.
- Be sure to take prenatal vitamins with folic acid before you get pregnant to help prevent neural tube defects, particularly spina bifida.
What Are The Risks?
Infertility: A women's body just naturally starts to become less fertile in her 30s. It may take longer for you to get pregnant as you get older. Other conditions that may contribute to infertility include endometriosis, uterine fibroids (benign growths in the uterus), and blocked fallopian tubes.
Increased risk of genetic abnormalities: As women age, their eggs do not divide as well, and genetic problems can occur. The most common genetic disorder is Down syndrome. Down syndrome is caused by the presence of an additional chromosome that causes mental retardation and defects of the heart and other organs. While the risk is still relatively low, it does go up significantly at age 35 and older. There are two tests now available for detecting chromosome abnormalities relatively early into the pregnancy: amniocentesis and chrorionic villus sampling (CVS). These tests do create a slight risk for miscarriage. If you choose to have the testing done and there is an abnormality, you will have to decide if you want to continue or terminate the pregnancy.
Loss of Pregnancy: A woman older than 35 has a higher risk of miscarriage than younger women. For a woman over 40, the risk doubles compared to a woman in her 20s and early 30s. Most of the time, these miscarriages are from genetic abnormalities that are more likely in women over 35.
Health problems during pregnancy: Some common medical conditions in women over 40 are diabetes and high blood pressure. If you have one of these conditions, it will make you more susceptible to problems while you are pregnant. Even if you don't have these conditions, older women are more likely to develop gestational diabetes and pregnancy-related high blood pressure. Additionally, there is a higher risk of placental and bleeding problems during pregnancy.
Pre-eclampsia: The risk of pre-eclampsia and eclampsia is greater in women having their first baby at a later age. The reasons for this are not well understood. In some cases, it happens as a result of having diabetes or high blood pressure before getting pregnant. Eclampsia is a serious complication that can occur during pregnancy. It may cause high blood pressure, swelling of your face and hands, and protein in your urine. Subsequently, it can impair your nervous system and cause seizures, stroke, or other serious complications.
Labor Problems: The risk for having labor problems increases for women over 35 and even more for women over 40 who are having their first child. Studies have shown that older women have a greater chance of prolonged second stage labor and fetal distress. This increases the likelihood of a forceps or vacuum-assisted vaginal delivery or a C-section.
Multiple Births: The incidence of having twins or triplets is increased in later life pregnancy even without infertility drugs. Multiple-birth pregnancies are considered higher risk.
Things To Do To Promote A Healthy Pregnancy
Although having a baby at a later age may put you at higher risk for complications, the majority of older women have healthy babies. Once you have educated yourself about the potential risks, you can turn your focus on all the things that go with a healthy pregnancy at any age. These include proper nutrition and diet, good prenatal care, and preparation both emotionally and financially for your baby and the care that will be needed.
There can be advantages to waiting until you are older to have a baby. Older women and men often find that they are more patient and realistic in coping with the challenges of a new baby than they would have been earlier in life. Likewise, they may have a greater appreciation of the joys of parenthood.
Review Date: June 29, 2001
Reviewed By: Peter Chen, M.D., Obstetrics and Gynecology, University of
Pennsylvania School of Medicine. Review provided by VeriMed Healthcare
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