Pregnancy after 35, is it safe & Benefits of Later-Age Motherhood

June 28, 2017
Foodviki
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As the average age at marriage rises in the U.S., so does the average age of new mothers. If you're an older mom, you're not alone. About 11 percent of babies born in the U.S. each year have moms over the age of 35. Recent studies, however, have shown that women who postpone childbearing do face some special risks, including: infertility and miscarriage, premature delivery and stillbirth, gestational diabetes, bleeding complications, hypertensive disorders of pregnancy, C-section, chromosomal abnormalities in babies, growth retardation in babies, and delivering multiples.


So what can you do? All women should monitor their reproductive health. If you are over age 35, follow the guidelines outlined in this to help ensure the best possible condition for your pregnancy.

How does age affect fertility?

As women reach their thirties, they experience a decline in fertility. The fertility regulator HFEA says female fertility declines sharply after a woman reaches the age of 35.

Complications during pregnancy are also more common when women reach 35.

Age-related decline in fertility may be due, in part, to the following:

  1. A decrease in the number and health of the eggs to be ovulated.
  2. Changes in the hormones resulting in altered ovulation.
  3. Fewer eggs.
  4. A decrease in sperm count.
  5. A decrease in the frequency of intercourse.
  6. The presence of other medical and gynaecological conditions, such as endometriosis, which may interfere with conception.


Pregnancy after 35, is it safe?

While advances in medical care can help women over age 35 have safer pregnancies than in the past, infertility and pregnancy complications for this age group are higher than for younger women. If you have decided to delay having a child, you should understand the risks associated with this so you can take precautions to minimise risks and improve your chances for a healthy pregnancy and child.

Pregnancy after 35, does the risk of birth defects increase?

The risk of giving birth to a child with a birth defect does increase as the mother's age increases. This is probably due to abnormal division of the egg, called nondisjunction. This leads to unequal chromosomes at the end of division. The risk of a baby having Down's syndrome increases with the mother's age when she gives birth. The greatest risk at around one in 30 is linked to women who are 45 or over when their baby is born.



Pregnancy after 35, will the risk of miscarriage increase?

Studies show that the risk of miscarriage (loss of a pregnancy before 20 weeks gestation) is 12% to 15% for women in their 20s and rises to about 25% for women at age 40. The increased incidence of chromosomal abnormalities contributes to this increased risk of miscarriage in older women.

Pregnancy after 35, what other problems can arise?

  • Long-term health problems, such as diabetes and high blood pressure, are more common in women in their 30s and 40s. Be sure to get these conditions under control before you become pregnant, since they pose risks to both you and your baby. Careful medical monitoring, commenced before conception and continued throughout your pregnancy, can reduce the risks associated with these conditions.
  • High blood pressure and diabetescan develop for the first time during pregnancy, and women over the age of 30 are at increased risk. If you are pregnant and over age 35, this makes it especially important that you get early and regular antenatal care to ensure early diagnosis and correct treatment.
  • Stillbirth(delivery of a baby that has died before birth) is more common in women over age 35. Older women are also more likely to have low-birth weight babies (weighing less than 5.5 pounds at birth).
  • Caesarean birthis also slightly more common for women having their first child after age 35.

Pregnancy after 35, how can I increase my chances of having a healthy baby?

Good health prior and during pregnancy will help you reduce your risk of complications. Here are some general recommendations.
  • Be sure to get enough folic acid in your diet. The current recommendation for women of childbearing age is to take a daily supplement containing 400mcg (micrograms) of folic acid whilst trying to become pregnant and for the first 12 weeks of pregnancy, in addition to consuming foods naturally rich in folic acid. Folic acid is naturally contained in leafy green vegetables, dried beans and some citrus fruits.
  • Limit your caffeine consumption. Current recommendations from the NHS are to limit caffeine to no more than 200mg a day. That's around 2 mugs of instant coffee. Caffeine is also found in cola, tea, energy drinks and chocolate.
  • Maintain a healthy, well-balanced dietand eat a variety of foods to get all the nutrients you need. Choose foods high in starch and fibre. Make sure you are getting enough vitamins and minerals in your daily diet. Pregnant women are also advised to take a 10mcg (microgram) supplement of vitamin D each day.
  • Exercise regularly. Review your exercise programme with your doctor or midwife. Generally, you may continue your normal exercise routine throughout pregnancy unless you are instructed to decrease or modify your activities.
  • Avoid alcohol during pregnancy and while trying to get pregnant.
  • Don't use any medication unless recommended to do so by your doctor.
  • Don't smoke during pregnancy.

In addition, be sure to obtain antenatal care, especially early in your pregnancy. The first eight weeks are especially critical in your baby's development. Early and regular antenatal care (health care during pregnancy) can increase your chances of having a healthy baby.

Regular appointments with your doctor and midwife throughout your pregnancy are important to monitor your health and prevent or control any problems that develop during pregnancy. In addition to medical care, antenatal care includes education about pregnancy and childbirth, plus advice and support.

Pregnancy after age 35, what types of antenatal tests should I have?

Because women over age 35 are more likely to have certain problems during pregnancy, the following tests may be recommended. These tests can help detect disorders before, during, and after your pregnancy. Some of these tests require appropriate genetic counselling, including a detailed discussion regarding the risks and benefits of the procedure(s). Whether you choose to have the tests is up to you. Talk to your doctor or midwife to find out if any of these tests are right for you.

Ultrasound: a scan in which high-frequency sound waves are used to produce an image of your baby. Ultrasound is used early in pregnancy to determine viability (if the baby is in the uterus and if the baby's heart is beating), the presence of more than one foetus, and to determine your baby's due date or gestational age (the age of the foetus). Later in pregnancy, scans may be used to see how the baby is doing, to determine placenta location and the amount of amniotic fluid around the baby.


According to the NHS, other tests that may be offered to women over 35 are:

The nuchal translucency scan: Women may be offered a nuchal translucency (NT) scan between 10 and 14 weeks of pregnancy as part of the screening for Down’s syndrome. Studies have shown that the thickness of the nuchal pad (pocket of fluid at the back of the baby’s neck) is related to the risk of Down’s syndrome. The NT scan enables a measurement to be taken, which can help assess the chance of your baby having Down’s syndrome.

"Double", "triple" and "quadruple" test: These screening tests measure the level of hormones in the blood. They offer an 'estimation of risk' for chromosomal abnormalities such as Down’s syndrome. The tests are available to anyone free of charge at around 16-18 weeks of pregnancy. These tests can also help detect the presence of twins or women who may be more advanced, or not as advanced as thought, in their pregnancy. Abnormal test results have been associated with premature delivery, low birth weight babies, and miscarriage. Around 65% of Down’s syndrome cases and 85% of neural tube defects are detected by these tests.



Amniocentesis: Amniocentesis, also called an 'amnio', is a procedure in which a small amount of amniotic fluid is removed from the sac surrounding the foetus and tested for birth defects. While it does not detect all birth defects, it can be used to detect sickle cell disease, cystic fibrosis, muscular dystrophy, Tay-Sachs disease, and Down’s syndrome if the parents have a significant genetic risk. Amniocentesis can also detect certain neural tube defects (where the spinal cord or brain don't develop normally) such as spina bifida and anencephaly. Because ultrasound is performed at the time of amniocentesis, it may detect birth defects that are not detected by amniocentesis (such as cleft palate, cleft lip, club foot, or heart defects). There are some birth defects, however, that will not be detected by either amniocentesis or ultrasound.

Chorionic villus sampling (CVS): a test in which a small sample of cells (called chorionic villi) is taken from the placenta where it attaches to the wall of the uterus. Chorionic villi are tiny parts of the placenta that are formed from the fertilised egg, so they have the same genes as the foetus. If you have certain risk factors, you may be offered CVS as a way to detect birth defects during early pregnancy. CVS requires appropriate genetic counselling, including a detailed discussion regarding the risks and benefits of the procedure.

Boost Your Nutrition

Time to really focus on what you're eating! Include a wide variety of nutritious foods in your daily diet. And make sure you're getting enough Folic acid, too. In addition to it being a part of your prenatal supplement, add Folic acid-rich foods in your diet; spinach, beans, lentils, and sunflower seeds are all good sources.

The Benefits of Later-Age Motherhood

Although later-age pregnancy can put you at higher risk for a number of health complications, there are some positive aspects. As a potential older mother, you may be more mature, realistic, and dedicated to the idea of having a baby than would a very young mother. It is also likely that you have given great consideration to the changes a new baby will bring to your life, so you'll be better prepared to face the challenges and adjustments ahead.

Women should be aware of the risks associated with delayed childbearing so they can make informed decisions on when to start their families. And since about half of all pregnancies for women in the United States are unplanned, any woman who is capable of conceiving should follow guidelines to promote reproductive health.

Further reading:

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