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Pregnancy Guide
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Pregnancy After 35
Pregnancy After 35
Pregnancy After 35
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A pregnancy after age 35 requires special precautions, but it also provides special rewards.
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InteliHealth
2009-07-01
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InteliHealth Medical Content
2011-07-17

Reviewed by the Faculty of Harvard Medical School

Pregnancy and a Woman's Age
 
If you're older than 35 and pregnant, you're in good company as more women are having children later in life.

A pregnancy after age 35 may require some special precautions, because it can be riskier than childbearing during the optimum years of ages 20 through 34. While age 35 has often been used to define pregnancies at "advanced maternal age," there is nothing special about 35. The risks increase gradually as women age. Just as a 35-year-old woman is more likely to have pregnancy issues compared to a 30 year old, the same is true for a 25 year old compared to a woman age 20.

The good news: Advances in medical care have made pregnancy safer than ever before. And most women in their late 30s and 40s have healthy pregnancies and babies.

Sill, there are factors to keep in mind if you're considering a prgnancy after age 35:

Decreased fertility. It may take you longer to become pregnant because there's a general decrease in fertility that begins in the early 30s. That's when women typically begin to ovulate less frequently. Other problems may also occur that decrease the chance of conceiving. So if you're older than 35 and have been unable to conceive after six months, consider seeing your doctor or a fertility specialist because many of these "infertility" cases can be treated.

Greater risk of miscarriage. Compared to teens, women older than 19 have lower rates of miscarriage, premature delivery and stillbirths. The bodies of teen-age mothers are still developing and these mothers are more likely to live in socially and economically disadvantaged circumstances, use illegal drugs and alcohol during pregnancy, have poor nutrition, and have inadequate access to health care. But then as women get older they face higher rates of miscarriage. Women older than age 40, for example, may face substantially higher rates of miscarriage as high as 40 percent. Most of these miscarriages are caused by chromosomal abnormalities, which are more common in women older than 35.

More health problems during pregnancy. As women get older they are more likely to have health problems including many that can affect a pregnancy. Women older than 35, for example, are twice as likely as those in their 20s to develop high blood pressure or diabetes during pregnancy — conditions that could adversely affect the mother and fetus during pregnancy. They also face a higher risk of placental and bleeding problems during pregnancy. Older women are also at higher risk for developing pregnancy specific conditions such as preeclampsia and gestational diabetes.

Complicated delivery. Older women are at higher risk for undergoing cesarean delivery. Women aged 35 through 39 may have a 27.4% chance of delivering by cesarean section. And those aged 40 through 49 have a 31.6% chance, higher rates than those of younger women. An older woman may also have longer labor and more fetal distress. But age may not be the only factor. Some of the increase likely results from underlying medical problems and/or the more frequent use of induced labor. They're also more likely to give birth to twins or triplets.

Greater risk of genetic disorders. One of the biggest concerns of an older pregnancy is a higher likelihood of having a child with certain genetic disorders. The most common such age-associated issue is Down syndrome, a condition caused by the presence of an additional chromosome that is associated with mental retardation and other physical abnormalities.

At age 25, a pregnant woman has a 1 in 1,250 chance of delivering a Down syndrome baby; at age 30, it's 1 in 952; at age 35, 1 in 385; and at age 40, 1 in 106. Prenatal testing such as amniocentesis or chorionic villi sampling (CVS) can detect genetic abnormalities such as Down syndrome early in the pregnancy.

Women now have the option of screening tests for genetic disorders that are less invasive. These tests cannot tell for certain if there is an affected pregnancy. But they may indicate a risk low enough that parents feel comfortable skipping diagnostic testing with amniocentesis or CVS. Conversely, screening tests may show a risk high enough to help others become more comfortable proceeding with diagnostic testing and the risk of miscarriage such tests bring.

Recently, it has become common to have blood tests and a special ultrasound called a nuchal translucency screening during the first trimester to screen for abnormalities. Another new screening test looks in a mother's blood for small amounts of fetal DNA.

To help ensure a healthy pregnancy, it's essential that all women follow these basic rules of pregnancy:
  • Get early and regular prenatal care, ideally starting before conception.
  • Eat healthy before and during pregnancy, and try to achieve proper weight for your height before you conceive. Your doctor will likely recommend a specific diet.
  • Take 400 micrograms (.4 milligrams) of folic acid each day, starting prior to pregnancy. You'll get this amount in most multivitamin supplements. Besides supplements, foods rich in folic acid include romaine lettuce and other green, leafy vegetables; dried beans; oranges; and wheat germ.
  • Don't drink or smoke during pregnancy. And avoid using any drugs during pregnancy — including over-the-counter medications — unless your doctor says it's OK.

 

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