If you get pregnant after turning thirty-five, it is usually called an advanced age pregnancy. Don't worry, it is not a unique thing in this day and age. Many families choose to delay pregnancies until they are financially stable. But you do need to take some special care of yourself and your unborn baby, just to make sure you are both receiving the best care possible for a healthy pregnancy.
Some of the factors to consider when going for an advanced age pregnancy, and possible risks associated include:
- Conception becomes harder.Many couples try and try and find it hard to conceive even after multiple tries. This is because, after the age of thirty-five, your egg reserve starts to deplete. This is why it is a good idea to involve a gynaecologist if you are above the age of thirty-five and haven’t been able to conceive after trying for 6 straight months.
- The chances of a twin pregnancy increase.Since conception becomes harder, many couples turn to artificial methods of fertilization. These methods have always been linked to a higher risk of multiple pregnancies. But even if you don’t choose assisted reproduction methods, just your age factor is likely to increase the chances of a multiple pregnancy, this is because of the changes in hormonal levels.
- Increased risk of gestational diabetes.Gestational diabetes is a kind of diabetes that only occurs during pregnancy, but it does increase the risk of developing diabetes later on in life too. Unfortunately, if you get pregnant at an advanced age, you are at an increased risk of developing gestational diabetes. This can have many adverse effects on the baby if not diagnosed and treated properly. For example, it can cause the birth weight of your baby to be on the higher side, the scientific term for this condition is macrosomia. This condition not only complicates the pregnancy but also increases the risk of your baby developing diabetes.
- The risks for a mother with gestation diabetes include developing high blood pressure, having a premature birth and increased complications during delivery.However, if this condition is diagnosed at the right time, and is treated well by maintaining blood sugars through diet, exercise and sometimes medications, there is nothing to worry about.
- The risk of developing high blood pressure during pregnancy is higher.Increased risk of developing hypertension. Hypertension is chronically increased blood pressure. Of course, such a condition is common as you grow older. However, your specialist will guide you in managing both your pregnancy and any chronic condition you have together.
- Increased risk of premature delivery.Premature delivery not only causes complications during the delivery for the mother but also for the baby as birth before time can increase the risk of developing fatal respiratory conditions such as ARDS.
- Increased risk of miscarriages.This has to do with the fact that eggs become harder to fertilize with age because of hormonal changes. But it can also be because of the development of other chronic conditions by the age of 35, like high blood pressure. Another reason for miscarriages is also the development of chromosomal abnormalities in your baby.
- Increased chances of Caesarean delivery.This can be due to complications developed by the above-mentioned conditions.
If you pay special attention to certain aspects of your advanced age pregnancy, you can avoid all of the risks mentioned above and continue a full-term healthy pregnancy ending with a completely healthy baby. Although an advanced age pregnancy is not treated much differently than a young age pregnancy, certain aspects of it do need proper care, such as going for screening tests to detect genetic disorders and ensuring closer monitoring throughout.
See an OB/GYN before your pregnancy.
Of course, you will probably make a visit to your health care provider at some point. But it is crucial to do so even before you are pregnant. This is called a preconception appointment. At this appointment, your specialist will discuss the overall health of you and your partner. They will also brief you about the risks associated with an advanced-age pregnancy and how to avoid them. They will also be available to guide you towards the option of assisted reproduction if conception is becoming hard. Research has shown that it becomes harder to become pregnant after 35 as fertility decreases. A decline in fertility is defined as a decrease in the quality and quantity of egg reserve available in the ovaries. In the mid to late 30s, fertility starts to decline more rapidly and the risk of complications increases.
The ultimate goal of a preconception appointment is to assist with conception if required, reduce the potential harms associated with an advanced age pregnancy and identify modifiable risk factors (risks/diseases that can be avoided with proper care) and prevent them. For example, advanced maternal age is associated with a greater risk of pregnancy-induced hypertension, gestational diabetes mellitus, pre-eclampsia, small for gestational age baby, spontaneous late preterm delivery, and cesarean section. A preconception appointment can help address these issues by taking preventive measures and managing them properly if they still develop along the course of pregnancy.
Visit your OB/GYN regularly to ensure your preventive care is up-to-date.
Doctor visits will become more abundant if you get pregnant at an advanced age. This is simply to monitor the progress of you and your child to avoid any adverse outcomes such as an increased risk of miscarriage, chromosomal abnormalities such as Down’s syndrome, eclampsia, gestational diabetes mellitus and in turn macrosomia (excessive birth weight) in baby, fetal growth restriction, preterm delivery, and even stillbirth. It helps in diagnosing and treating conditions at an early stage. And of course, visiting your specialist will help you stay stress-free about any concerns you may have during your pregnancy.
Keep any existing medical conditions under control.
If you already have any chronic disorders such as hypertension or diabetes mellitus, it is even more important to keep them under control during your pregnancy. If left untreated or you tend to skip your medicines, the chances of complications increase a great deal.
Discuss low-dose aspirin prophylaxis with your OB/GYN.
Advanced age pregnancy itself is considered a moderately dangerous risk factor. When combined with another moderate or high-risk factor, aspirin can be added as a preventive measure to the maternal treatment regimen. These risk factors include first pregnancy, obesity, family history of pre-eclampsia in mother or sister, previous pregnancy with fetal growth restriction, poor socioeconomic status and African American race.
Low-dose aspirin can help prevent or delay the development of pre-eclampsia. It can also help decrease the risk of fetal growth restriction, miscarriage, preterm birth and stillbirth.
Go for regular maternal checkups/screening tests.
Another reason advanced age pregnancy can lead to adverse outcomes is declining maternal health. With age, the chances of developing chronic disorders such as diabetes mellitus, and hypertension increase, especially when you also have a genetic predisposition. These chronic disorders can affect the baby as well as overall maternal well-being. Diagnosing and treating these conditions at an early age is crucial for both fetal and maternal well-being.
Moreover, there is a greater risk of placenta previa and breech positioning of the baby in advanced-age mothers. Regular healthcare checkups can help detect these conditions early on and manage them accordingly.
Opt for Prenatal Screening tests.
As mentioned before, advanced maternal age is associated with a decline in egg quality that increases the risk of genetic disorders such as trisomy 21. When you go for your initial visits after your pregnancy, your specialist may recommend a few tests to see whether your baby has developed any chromosomal abnormalities that may lead to conditions like Down’s syndrome, trisomy 13, trisomy 21, and trisomy 18.
Unfortunately, the development of such conditions is more common in advance age pregnancies. However, some simple screening tests during the first trimester will alert you and your specialist at the right time to make a decision about your pregnancy.
Keep track of what you eat.
This is crucial as all pregnancies require an influx of certain nutrients during certain stages of pregnancy to avoid deficiencies and diseases for both you and your baby. For example, Folic Acid should be taken well before you get pregnant and continued to the first trimester to avoid neurological illness developing in your baby. Iron supplements are recommended until the second trimester to avoid the development of severe anaemia as your body now needs to make enough blood to supply two people!
Additionally, it is important to maintain your calcium and vitamin D levels to ensure a positive pregnancy outcome as well as maternal health. Without adequate nutrition, advanced-age pregnancies are at a greater risk of fetal growth restriction and complications during delivery. A deficiency of key nutrients like iron, folate, calcium, and iodine can cause a greater risk of pre-eclampsia, anaemia, excessive bleeding (haemorrhage) and even death in advanced-age mothers.
Also, there are some dietary and lifestyle restrictions that come with pregnancy, like limiting alcohol intake and quitting smoking, if either of these habits gets out of hand, they can cause premature delivery and even abnormalities in your baby. Although these are generally applicable for all pregnancies, it is even more important to be mindful in high-risk pregnancies such as many of those in advanced age. And of course, you need to maintain a generally healthy diet as well. Your specialist can help you make a detailed diet plan for yourself.
Maintain an active routine.
You already know that physical activity is a must for anyone at any age, but it is also recommended to keep active during pregnancy, especially if it is an advanced age one. This is because it helps boost your overall energy, increase stamina, and muscle strength, which will be put to great use during your labour! However, check with your healthcare provider before you start any new exercise routines, especially if you are suffering from any co-morbid (like diabetes, hypertension or heart disease) conditions that are more likely at an older age.
Additionally, it is important to maintain a normal weight if you are overweight or underweight before pregnancy. A weight gain of up to 10kgs during pregnancy is normal and encouraged.
Pregnancy is a beautiful journey, though it can also be challenging if proper care is not taken. It is crucial to educate yourself regarding the possible risks and outcomes of an advanced-age pregnancy. However, it is also important to know that not all advanced-age pregnancies are risky and some may proceed completely normally. But is always a good idea to educate yourself. Check out our blog to know more about pre-conception, pregnancy, delivery and parenting a newborn.