Risk of Pregnancy Advanced Age

There are risks associated with advanced maternal age, defined by age 40 and older

Many women are delaying childbearing until their 30s and 40s, but there are risks associated with pregnancy and advanced maternal age.

First time mom age increasing

In 1999, the average age of first time moms in this country was 24. By 2014, that number had climbed to 26. Data from the same year revealed 9.1 percent of first time moms were over age 35.

There are a number of reasons why women delay childbearing. Education, career development, waiting to meet the right person and finances are just a few of factors behind the maternal age increase. And while there are advantages (financial stability, maturity, work schedule flexibility), there are also health risks associated with delayed childbearing.

Risks associated with pregnancy and advanced maternal age

It is certainly possible for a woman to have a healthy baby in her 30s or even 40s, but getting pregnant may be more difficult and the complication risk higher.

A woman’s ability to reproduce begins to decline around age 32 and progresses naturally from there. Around age 37 the decline becomes more rapid, primarily due to decreasing egg quality and quantity. By age 44, the vast majority of women are no longer fertile.

Pregnancy in a woman of advanced maternal age is likely to be more difficult and all pregnancies in women over age 35 are considered to be high-risk. Factors that make pregnancy for older moms riskier include:

  • Poor quality, older eggs that may result in poor embryo quality and chromosomal abnormalities including Down Syndrome
  • Older moms are more likely to have pre-existing health conditions such as diabetes and high blood pressure
  • Greater risk of spontaneous abortion and miscarriage
  • More likely to develop pregnancy complications such as gestational diabetes and high blood pressure (pre-eclampsia and eclampsia)
  • Increased risk of low birth weight
  • Higher risk of premature and stillborn births
  • More likely to have complications such as placenta previa requiring C-section delivery
  • Rate of multiples higher in older moms (use of reproductive technology increases odds)

Steps for healthy pregnancy after 40

Obstetric management is extremely important for women of advanced maternal age. Women age 40 and over who wish to become pregnant should take the following steps:

  • Schedule a preconception appointment with an OBGYN
  • If pregnancy has not occurred within 6 months of trying, a consultation with a fertility specialist – reproductive endocrinologist – is warranted. Some women over age 40 opt to see a fertility doctor sooner
  • Take steps to protect health: eat healthfully, maintain a healthy weight, kick bad health habits such as smoking or drinking alcohol and stick to a regular exercise routine
  • Be vigilant about keeping all prenatal appointments

Monitoring a high-risk pregnancy

Since all pregnancies after age 35 are considered high-risk, a number of special tests may be recommended including:

  • Ultrasound testing – may include high-resolution or 3D ultrasound to assess fetal health and development
  • Chorionic Villus Sampling (CVS)– uses tissue taken from the placenta to test for genetic conditions and chromosomal abnormalities
  • Amniocentesis – uses amniotic fluid taken from the uterus to test for genetic abnormalities and fetal developmental maturity
  • Doppler blood flow studies – used to monitor fetal anemia and growth
  • Maternal blood and/or lab tests—to check for infections or other health conditions
  • Cordocentesis –also called Percutaneous Umbilical Cord Blood Sampling (PUBS), uses a fetal blood sample taken from the umbilical cord to test for genetic conditions

Women who have a high-risk pregnancy due to advanced maternal age should report any changes in their health or pregnancy to their OBGYN immediately. Staying vigilant and following recommended precautions help to keep both mom and baby safe.