Advanced Maternal Age – Risks and Precautions
Author: Phylana Stowers, RN, BSN
In the 13 years I've been working in the maternity unit, I have seen more and more women who have waited until they were 35 or older to have children. Of course, there are as many different reasons to wait as there are women, but the most common reasons seems to stem from the desire to wait until attaining a stable family base and/or being financially stable. Also, the improvement of medical science and fertility treatments has made it possible for older mothers, and women who previously were unable to conceive, to have a chance to have a baby.
If a woman is over the age of 35, she is considered to be of Advanced Maternal Age, and with this title comes risks for mom and baby.
- Increased risk of Down Syndrome - the most common chromosomal birth defect (chromosomes - cells that carry genes and transmit heredity information)
- Increased risk of miscarriage
- 20% increase at ages 35 to 39
- 35% increase at ages 40-44
- Over 50% increase by age 45
- Increased risk of Cesarean Section (C-Section) for delivery method
- Gestational diabetes - diabetes that develops for the first time during pregnancy. Women who have this could possibly have a very large baby who then is at risk for injuries during delivery.
- Pregnancy Induced Hypertension - High blood pressure
- Placental Problems - one of the most common placental problems is placenta previa in which the placenta covers all or part of the uterine opening (cervix). This can cause severe bleeding during delivery and can make C-section delivery necessary.
Even with all of these increased risks, with the advancement in medical procedures and testing, there are several ways to reduce your risk. They include early and regular prenatal care, taking the multivitamin with folic acid prescribed by your health care manager, beginning pregnancy at a healthy weight, not smoking or drinking alcoholic beverages, and eating healthy foods.
There are tests that all pregnant women are encouraged to take, but there is additional prenatal testing that is regularly offered to any woman 35 or older because of the potential of increased risks to the mother and baby. These tests are chorionic villus sampling (CVS) and amniocentesis.
With CVS, a small sample of cells (called chorionic villi) is taken from the placenta where it attached to the wall of the uterus. Chorionic villi are tiny parts of the placenta; therefore they have the same genes as the baby. This test is 98% accurate, but can carry a slightly higher risk of miscarriage than amniocentesis, since the procedure is done in early pregnancy.
Amniocentesis is a procedure where a sample of fluid is removed from the amniotic sac for analysis and evaluation. During this procedure, fluid is removed by placing a long needle through the abdominal wall into the amniotic sac. The amniocentesis needle is typically guided into the sac with the help of ultrasound imaging. Once the needle is in the sac, a syringe is used to withdraw the clear amber-colored amniotic fluid, which looks a bit like urine.
Both of these tests, CVS and amniocentesis, let couples know if the fetus will have genetic abnormalities, and will help them make informed decisions regarding their pregnancy.
It is amazing how far science has come. There was a time when once you were a certain age, it was said that your biological clock had ticked out and your time for having a baby had passed. We are in a time that allows for the use of the snooze button on the biological clock, which gives women a little "extra" time. Every pregnancy comes with risks, but with a little information and dedication to your health, the payoff can be amazing.
