If you are considering pregnancy, it is advisable to meet with a healthcare provider to discuss your overall health, any pre-existing conditions, and any steps you can take to optimise your health before conceiving, advises Dr Kiran Coelho.
Advanced maternal age (Age more than 35 years during conceiving) has become a norm due to changing lifestyle, need for financial stability and increased educational needs.
While it is common for women to have healthy pregnancies and deliver healthy babies at this age, there are certain complications and considerations that may arise.
Here are some complications and tips to keep in mind for late pregnancies:
1. Increased risk of chromosomal abnormalities
The risk of chromosomal abnormalities, such as Down syndrome, increases with maternal age.
Prenatal screening tests and diagnostic tests like amniocentesis or chorionic villus sampling (CVS) can help detect these conditions.
Tip: Discuss the available screening options and genetic testing options with your healthcare provider to make an informed decision about which tests are right for options
2. Higher risks of miscarriage
Increased age increases rates of miscarriages. This is mainly due to increased risk of chromosomal abnormalities and fetal defects, which are incompatible to life.
Tip: Preconception Planning: If you are considering pregnancy, it is advisable to meet with a healthcare provider to discuss your overall health, any preexisting conditions, and any steps you can take to optimise your health before conceiving.
Starting folic acid supplements 3 months prior to pregnancy and continuing it 3 months post pregnancy helps reduce this risks.
3. Higher incidence of gestational diabetes
Older women have an increased risk of developing gestational diabetes during pregnancy, which can lead to complications for both the mother and the baby.
4. Increased Risk of Hypertensive Disorders
Women of advanced maternal age have a higher likelihood of developing high blood pressure and preeclampsia during pregnancy.
Tip: Maintain a healthy lifestyle by eating a balanced diet, exercising regularly (with your healthcare provider's approval), managing stress, avoiding harmful substances like tobacco, alcohol, and illicit drugs and attending prenatal appointments to monitor and manage any potential complications.
Monitoring BP throughout pregnancy for early detection and treatment.
5. Decreased fertility and longer time to conceive
As a woman gets older, her fertility declines, and it may take longer to conceive. This can be attributed to a decrease in the quantity and quality of eggs.
Tip: If you are planning a pregnancy and are concerned about your fertility, consider consulting a fertility specialist who can assess your individual situation and provide guidance on fertility treatments if necessary.
6. Increased chance of multiple pregnancies
As women age, the likelihood of conceiving twins or higher-order multiples (such as triplets) increases.
Multiple pregnancies carry a higher risk of complications, such as preterm birth and low birth weight.
Tip: Regular prenatal care and monitoring are crucial in managing the unique challenges associated with multiple pregnancies.
Your healthcare provider will closely monitor your progress and provide appropriate guidance.
7. Higher risk of stillbirth
The risk of stillbirth slightly increases with advanced maternal age. However, it is important to note that most pregnancies in women over 35 result in healthy babies.
8. Increased Risk of Preterm Birth
Advanced maternal age is linked to a slightly higher risk of preterm birth, which can result in potential complications for the baby.
Tip: Attend all recommended prenatal appointments, and notify your healthcare provider immediately if you experience any unusual symptoms, such as bleeding, severe abdominal pain, or reduced fetal movements.
9. Increased risk of cesarean delivery
Older women have a higher likelihood of needing a cesarean section (C-section) compared to younger women. This can be due to various factors, such as an increased incidence of pregnancy complications or an increased preference for planned C-sections.
Tip: Discuss your birth plan with your healthcare provider, and be open to different possibilities.
Understanding the reasons behind a potential recommendation for a C-section can help you make an informed decision.
10. Postpartum Depression
As compared to younger women, the chances of postpartum depression are more in women of higher age. Hence, complete knowledge about the pregnancy and related mood changes need to made available to the mother.
Tip: Seek emotional support from your partner, family, friends, or support groups.
Pregnancy can bring about various emotions, and having a strong support system can be beneficial.
Open communication with your healthcare provider both during pregnancy and postpartum can help reduce anxiety and stress.
Remember, these complications and risks are not universal and vary from woman to woman.
While advanced maternal age may pose some challenges, many women have successful pregnancies and healthy babies in their late thirties and beyond.
Regular prenatal care, a healthy lifestyle, and open communication with your healthcare provider are key to ensuring the best possible outcome for you and your baby.
Dr Kiran Coelho is a Consultant, Gynecology & Obstetrics, P D Hinduja Hospital & Medical Research Centre, Khar, Mumbai.
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