Now that I’m pregnant with my fourth baby at age 37, I’ve entered the category of “advanced maternal age.” While the vast majority of babies born to women my age and older are perfectly healthy, there are some additional risks related to pregnancy over the age of 35.
The most common risk associated with pregnancy over 35 is an increase in the risk of the baby having chromosomal disorders. The best known is Down’s Syndrome. The risk for this disorder climbs from 1 in 1250 at age 25, to 1 in 400 at age 35 and 1 in 100 at age 40. You may be offered testing to rule out Down’s Syndrome and other disorders.
A blood test known as the triple screen blood test, which is just a screening test, is offered to most women regardless of age. Other testing options are the amniocentesis and level 2 ultrasound. The amnio carries a risk of miscarriage, but it the most accurate. A level 2 ultrasound offers accuracy nearly as good as the amnio, when performed by a specialist in Maternal Fetal medicine.
The risk of other complications increases after the age of 35, especially with the first baby. Problems with the placenta are more common, particularly placenta previa. This occurs when the placenta grows in front of the opening of the cervix. This can cause severe bleeding during delivery and is dangerous to both mother and baby. Fortunately, this can be avoided with a c section.
The rates of miscarriage are higher among women over 35. A woman in her twenties has a 9% chance of having a miscarriage, while a woman in her thirties has a 20% chance. In addition, the risk of preterm labor and low birth weight increase with age. Your doctor will watch for signs of preterm labor. When caught early, it can sometimes be stopped.
Pre existing health conditions can cause problems at any age, but tend to be more prevalent in older mothers. A preconception visit is a good idea. Your provider will evaluate your health and address any concerns about health conditions you may have. He or she can evaluate treatments and medications to make any necessary changes or adjustments prior to pregnancy.
The risk of developing certain conditions of pregnancy is slightly higher for older mothers as well. The risk of pre eclampsia or gestational diabetes gets higher as women age. Pre eclampsia is related to high blood pressure in pregnancy. Your blood pressure will be checked at each visit. Your urine is checked for sugar and a glucose tolerance test will tell your provider if you are at risk of gestational diabetes.
While there are added risks for pregnancy in your thirties or forties, there is a lot that can be done to prevent them. Your doctor will evaluate your specific needs and monitor your progress. Regular prenatal care is the best way to avoid complications and intervene when needed.