Older and Expecting!

It is hard to believe, but it is true—by the time you are 35 they actually have an ageist term for you: Advanced Maternal Age.* You are an AMA. Someone clearly got it wrong. Most 35-year-old’s lives are only just beginning! Still, the term isn’t exactly incorrect. After the age of 35. the chances of having a healthy baby begin to diminish because an entirely new range of risk factors are present. This is in addition to the normal risks of pregnancy. And yet in today’s society, with contraception available and careers to pursue and manage, women are having children later and later. If you are 35 or over and pregnant, or thinking of having a baby sometime soon, here are a few things to keep in mind.

The risks
Infertility:
You are less likely to get pregnant as you get older. Those women older than 35 who still want to conceive after trying for 6 months are advised to consider fertility treatment.

Miscarriage:
A woman older than 35 has a higher risk of miscarriage and it continues to rise. In her 40s and over, the risk doubles compared to a woman in her 20s or early 30s. Most of the time, these miscarriages result from genetic abnormalities that begin to present in women over 35.

Increased risk of genetic disorders:
Every woman is born with all the eggs she will ovulate with for the rest of her post-pubescent and pre-menopausal life—this means that the egg a woman conceives with is as old as she is. So if you are 30, and your mother was 30 when she conceived you, then you are the product of an egg that developed 60 years ago! Statistically then, the genetic material within the egg is at a greater risk of being defective as the woman ages.

The most common genetic disorder in pregnancies of women past 35 is the absence or addition of a chromosome to the baby’s DNA. which causes Down Syndrome. A Down Syndrome baby will typically present some mental retardation, and defects in his or her organs. Although this risk is generally quite low. it goes up considerably at the age of 35 and then continues to rise. While at 35, the risk is 1 in 365. By 45, the risk is 1 in 32.

The standard tests for potentially high risk pregnancies are chorionic villus sampling (CVS) and amniocentesis. CVS testing can be performed as early as nine weeks, while Amniocentesis is usually not performed until the 14th to 16th week. Both tests carry a less than 1 per cent risk of triggering a miscarriage, but result may be that you are compelled to terminate the pregnancy.

Pre-eclampsia:
The risk of pre-eclampsia and eclampsia is greater in women having their first baby at a later age. Pre-eclampsia is a form of high blood pressure caused by pregnancy. Acute pre-eclampsia leads to eclampsia.

In eclampsia women develop convulsions and seizures. Tihs impairs the nervous system, and may even lead to stroke.

Labour Problems:
Women aged 35 and over are at a greater risk of experiencing preterm labour. Even where the labour is timely. 35 plus women have a greater chance of prolonged second stage of labour and foetal distress: especially if they are having their first child. Older women also have a higher risk of stillbirth.

Multiple Births:
Did you know that the likelihood of begetting twins or more naturally increases with each pregnancy? Worldwide, identical twins (which are formed from a single egg) are produced 1 in 250 pregnancies. Fraternal twins (formed from two different eggs) are much more likely to be born. The very number of previous pregnancies increase their chance of being produced. Between the first and a fourth pregnancy, the chance actually doubles. While African women have about 1 in 79 chance of producing fraternal twins, it is a virtual guarantee for a woman over the age of 35 who has had four or more children. It is worth noting that the chance of having fraternal twins is also heightened by a woman who has just stopped taking birth control pills!

Other risks:
Placental abruption (Premature placental separation), gestational diabetes, arthritis and stroke.

Tips on keeping healthy
Being over 35 and pregnant doesn’t worry doctors much more than teen pregnancies—both have their own special set of risks. As long as the mother is healthy and vigilant with her body, it is probable that the pregnancy will proceed smoothly.

There are things you can do to encourage a healthy and complication-free pregnancy:

– Remain informed about the risks and take those tests required to know what complications may be likely to crop up in your personal case.
– Ensure that you are in stable good health before you conceive and that any medical conditions you might have are in control. Do discuss pregnancy with your doctor and ask how it might affect your condition if any.
– Be religious about taking prenatal vitamins and folic acid, even before you conceive, to prevent spina bifida.
– Attend both childbirth and parenting classes to (re-)gain confidence in parenthood.

END:PG15/16