Advanced Maternal Age
26th Jan

2015

These days many women are delaying childbearing into their 30’s and it is not uncommon to be over 35 when having a baby.  Previously the term given to these pregnancies was “geriatric” but the updated (more politically correct) name is Advanced Maternal Age.

There are a number of considerations for pregnancies as we get older and knowing and mediating those risks can help result in a healthy mother and a health baby.

It may take a while to conceive….

Unfortunately as we get older, so do our eggs.  Egg quality and quantity decreases from birth but the decline starts to get more rapid in the late 30’s and early 40’s.  This can result in difficulties conceiving, a higher risk of miscarriage and a higher chance of a chromosomal abnormality for the baby such as Down Syndrome.  If you are older than 35 and have been trying naturally for 6-12 months without success, it may be worthwhile seeing a gynaecologist or fertility specialist for advice.

You are more likely to have a twin pregnancy….

This is due partly to the increased chance of needing IVF for conception, but is also related to the fact that two eggs may be released at once due to increased FSH hormone levels as you get older.

There is an increased risk of medical complications….

As women get older their chances of having diabetes and high blood pressure in pregnancy gets higher.  These complications of pregnancy need to be closely monitored and for this reason you may need to see your obstetrician more frequently.  Your risks of having a premature baby are also increased.

You may need to have a caesarean delivery….

There is a higher risk of needing a caesarean delivery due to the increased risk of complications of pregnancy as described above and potential for difficulties in labour.

It is not recommended to go over your due date….

This recommendation is due to the increased risk of stillbirth for babies of older mothers if they are postdates or overdue.  While the absolute numbers are low, studies have shown that your risk of still birth after 40 weeks is increased by approximately 50% if you are 35-39 years old and tripled if you are over 40 years old.  Your obstetrician may recommend an induction of labour in the week before your due date to reduce this risk.

The take home message is to try not to delay childbearing if you can avoid it, however if you are expecting a baby at over 35, be aware of the risks and maintain a close relationship with your obstetrician to make sure your pregnancy is as safe as possible.

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