Pregnancy after 35: Keep the risks in perspective

[David Baxter PhD]

Pregnancy after 35: Keep the risks in perspective
By Mary Murry, R.N., C.N.M., Mayo Clinic
July 31, 2010

More women age 35 and older seem to be having babies than ever before, so let's discuss pregnancy risks for older moms — and how to put the risks into perspective.
For starters, older moms have a higher risk of ectopic pregnancy — when the fertilized egg implants somewhere other than the uterus — as well as a higher risk of congenital anomalies. Scary? Yes. Still, the risks of pregnancy after 35 might not be as bad as they seem. For congenital anomalies, for example, it might be the difference between a 3.5 percent risk and a 5 percent risk. This would translate to a 95 percent chance of delivering a healthy baby.
In addition, normal age-related changes may predispose older moms to certain problems during pregnancy, such as:

• High blood pressure
• Diabetes
• Placenta previa — when the placenta partially or completely blocks the cervix — or other problems with the placenta
• Stillbirth — fetal death at or beyond 20 weeks of pregnancy

Here, too, it's important to keep your perspective. According to the American College of Obstetricians and Gynecologists, the risk of stillbirth for all pregnancies is less than 1 percent. For women ages 35 to 39, it's 1.1 to 1.4 percent. For women age 40 and older, it's 1.1 to 2.1 percent. Even with a higher rate of stillbirth, the odds of delivering a healthy baby are still strongly in your favor.

So what's the bottom line? Older moms face higher risks during pregnancy, but odds and statistics don't rule your pregnancy. Instead, take charge of your health:

• Manage chronic conditions. If you have a chronic medical condition — such as high blood pressure or diabetes — make sure it's under control before and during pregnancy.
• Choose your health care provider carefully. If you have a preexisting medical condition, you might consult a perinatologist — a health care provider who specializes in high-risk obstetrics. If you don't have access to a local perinatologist to manage your entire pregnancy, consider a single consultation with the nearest perinatologist for evaluation and help planning your future care.
• Be honest with your health care provider. Talk about the risks, and share your fears and concerns. Work together to create a responsible plan of care.

Don't go through your pregnancy on pins and needles. Trust nature, trust yourself and trust your health care provider.

See Also

• Pregnancy and exercise: Baby, let's move!
• Prenatal testing: Is it right for you?
• Sex during pregnancy: What's OK, what's not
• Prenatal vitamins: Give your baby the best start
• Twin pregnancy: What multiples mean for mom
• Childbirth education: Get ready for labor and delivery
• Working during pregnancy: Do's and don'ts
• Pregnancy nutrition: Foods to avoid during pregnancy
• Pregnancy weight gain: What's healthy?
• Pregnancy diet: Essential nutrients when you're eating for two
• Pregnancy nutrition: Healthy eating for you and your baby
• Video: Fetal ultrasound
• Slide show: Fetal ultrasound
• Pregnancy due date calculator

References

1. ACOG practice bulletin No. 102: Management of stillbirth. Obstetrics and Gynecology. 2009;133:748.