Pregnancy and Advanced Maternal Age

As more women focus on their careers, more women are getting pregnant and having children after the age of 35 years old, which means in the medical field that they are placed in a group of mothers that are classified as being of advanced maternal age. Not that many years ago most of the women if they were able to conceive, would not carry the child to term or would die before the baby was born, but because of advances in medical technology most of these women easily get pregnant and have normal pregnancies; however there are some issues and risks involved when having a baby during your later childbearing years.

As women age, they become less fertile and the ovaries do not always release an egg each month during the menstrual cycle which can be a cause of infertility. As you age there is also an increased risk that the baby will have a genetic disorder, like Downs Syndrome. There are always concerns for the mother and fetus during pregnancy, but for the woman who has hit advanced maternal age she will be specially monitored for problems related to her age. The risk of miscarriage increases to about 1 in 4 at the age of 35 and 1 in 3 after the age of 45, with the majority of these caused by a genetic problem with the baby. The advanced maternal age mother is more then twice as likely to develop high blood pressure or diabetes during her pregnancy as a younger woman under 35 years of age. There is also an increased risk of placental abruption and placenta previa in older mothers. Regular checkups during the pregnancy are always important, but with the mother of advanced maternal age checkups should be started earlier and more tests will be provided to monitor the fetus. Common tests offered to mothers over the age of 35 are blood test called AFP, triple screen, quad screen and/or integrated tests, which is done between 15 to 18 weeks pregnant and measures several different substances in your blood to look for a problem in the babies spine or signal a possible genetic problem. Another more invasive test called Amniocentesis and Chorionic villi sampling are tests used to check for genetic problems with the baby. Amniocentesis is done by drawing away a volume of amniotic fluid by inserting a needle, usually guided with ultrasound, through the mother’s skin where it crosses the uterine wall into then amniotic sac where the baby and fluid reside. It is most often done in the third trimester to test for lung maturity when there is a danger in allowing a high-risk pregnancy to continue and at 15 weeks to do genetic testing. Chorionic Villous Sampling (CVS) is a technique that uses a needle through the cervix (a vaginal approach) to biopsy some chorionic tissue (placental tissue). The cells retrieved can be tested for genetic abnormalities, yielding the same information that amniocentesis provides, but over a month earlier. With all tests there comes increased risks and worrying for the patient and family, teaching is especially important during these times. With the more invasive testing there comes an increased risk of miscarriage and then waiting for the results can also cause anxiety

Not all is negative for the mother who is of advanced maternal age, these women are usually more educated, financially stable and have good healthcare, and they are usually in good relationships with extended family support. Most women of advanced maternal age are encouraged to have genetic counseling prior to pregnancy to determine if they are at risk of having a baby with a genetic disorder such as Down syndrome and so therefore are more educated regarding these issues and better able to make decisions that might effect themselves or the future of the baby. Women of advanced maternal age should be provided the same instructions for prenatal care as a younger mother, such as to see her provider before getting pregnant and continue with checkups as scheduled. Like any other pregnant mother she should take a multivitamin everyday, eat a variety of healthy foods, plenty of rest and exercise. Teaching should be done when to call the doctor, such as having bleeding with or without pain, severe headache, problems with eyesight, severe swelling of the face, hands, ankles and feet, any fluid leaking from the vagina and having contractions before her due date. Because of all medical advances that have been made, mothers of advanced maternal age can safely get pregnant and carry the baby to term, these mothers are really just like any other pregnant women, but because of their age will need to be monitored a little more carefully for risks that could affect any pregnant women.