As women get older, their pregnancy risks increase. While support and medical care is provided, it is important to understand the risks of advanced maternal pregnancies, defined as a pregnant individual who will be 35 years of age or older at the expected birth of their child.
“Egg quality starts to decline with age, dropping around age 32, then again at 35, and then around 37 or 40,” says Dr. Matthew Carroll, assistant professor of obstetrics and gynecology at Baylor College of Medicine and Texas Children’s. Hospital.
Since most women don’t go through menopause until they are 50, they can still get pregnant at an advanced maternal age. Fertility technology and reproductive endocrinology also contribute to the ability to conceive above the age of 35.
Women over the age of 40 are most at risk for pregnancy complications. As women get older, they are more at risk for:
- preterm birth
- spontaneous miscarriage
- Ectopic Pregnancy
- Having a baby with a low birth rate
The older population also has more comorbid medical conditions when they become pregnant, which will increase the risk during pregnancy.
“As the mother’s age increases, the risk of chromosomal abnormalities and early pregnancies increases, and most of those will miscarry spontaneously or fail,” he said. “Children can be born with conditions such as Turner syndrome or Down syndrome.”
While everyone has their own medical history, health condition, and risk factors that come with them in pregnancy, pre-existing hypertension also increases the risk of complications. It is very common for pre-existing hypertension to progress to preeclampsia during pregnancy, which has consequences and risks for the pregnant woman, the fetus and the eventual baby.
Pregnant women over the age of 35 are more at risk of developing preeclampsia, a pregnancy complication that causes high blood pressure, protein in the urine, stress on other organs, and swelling. Most pregnant patients over the age of 35 are candidates for low-dose aspirin therapy to reduce the risk of preeclampsia.
“For patients who will develop preeclampsia anyway, we hope this delays the onset so that the pregnancy progresses and we have a less preterm baby,” Carroll said.
The risks of preterm birth are higher for women in this category. There are two types of preterm birth:
- Spontaneous Premature Birth: A pregnant woman’s bag of water ruptures and they go into labor spontaneously
- Indicated Preterm Birth: A pregnant woman develops severe preeclampsia between 34 and 37 weeks and has been made available for delivery on behalf of mother and fetus
Carroll recommends diagnostic tests for pregnant women over the age of 35 to check if parents are carriers of genetic disorders. Patients over 40 should have weekly ultrasounds and fetal heart rate monitoring after 37 weeks.
“This may be safe as long as doctors talk to patients about their risk factors,” Carroll said.
By Homa Shalchi