Pregnancy at age 34 risks
What You Should Know About Having a Baby After 34
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Minnesota Perinatal Physicians
Posted October 31, 2017
If you are thinking about having a baby in your late thirties or early forties, you are not alone. Women ages 35-45 are increasingly becoming first-time moms. And most healthy women in this age group have healthy pregnancies, births and babies. However, don't be surprised if your doctor talks to you about being at higher risk for certain conditions.
What changes at 35?
Truth be told, there is nothing dramatic about turning 35 in regards to having a baby. A woman's risk for general health issues and pregnancy-related health issues gradually increases every year — and there's not much difference between 34 and 35.
However, 35 is the age at which medical research indicates that risk factors related to pregnancy merit some more discussion. You are increasingly at risk for infertility issues, multiples, premature delivery, a chromosomal abnormality, a miscarriage or stillbirth, and abnormal fetal growth. And your chances of needing a C-section go up.
Your doctor may also watch you more closely for gestational diabetes and high blood pressure.
What you can do before you're pregnant
It's a good idea to schedule an appointment with your doctor before you get pregnant to discuss a pre-conception plan to ensure optimal health during a pregnancy. If you are healthy overall, a plan may include staying active, eating healthy and taking a prenatal vitamin.
If you are overweight, have diabetes, high blood pressure or another health issue, your doctor may want to work on a plan to help you address those issues before you become pregnant.
If you are experiencing difficulty getting pregnant, your physician may move more quickly to evaluate you for infertility treatments.
During your pregnancy
Your doctor may discuss your risk for some birth defects and genetic-related conditions, such as Down syndrome. You can talk with a genetic counselor to better understand the risk and to determine whether you would like to pursue any screenings.
Screenings to consider include:
- a first trimester screen that includes a blood test and a nuchal translucency, which is an ultrasound to measure the thickness of the tissue at the back of an unborn baby's neck
- a second trimester screen, which is a blood test known as a serum screening or "quad test" to determine whether the baby is at risk for certain birth defects
- a sequential screen — a combination of a first and second trimester screening
- a non-invasive prenatal testing (NIPT), which is a DNA blood test that screens for common chromosome abnormalities.
Other diagnostic tests to be aware of are chorionic villus sampling and amniocentesis.
Depending on your health and any pregnancy complications, you may require increased visits to your doctor. You will likely be referred for a Level II ultrasound, which is a detailed ultrasound evaluating the baby's anatomy. Your doctor may also recommend additional ultrasound exams, especially at the end of your pregnancy.
Whether you are in your twenties, thirties or forties, and whether you're having a low-risk or high-risk pregnancy:
- avoid alcohol, tobacco and any other drugs
- if you are taking medications, discuss their safety with your doctor
- see your doctor regularly and stay within pregnancy weight-gain guidelines
Putting it in perspective
As I said, there isn't anything really remarkable about turning 35. The best thing you can do at any age, if you are considering having a baby, is take good care of yourself and your body to prepare for a new life.
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Thinking About Pregnancy After Age 35? 3 Issues to Consider
More women are becoming pregnant later in life. Some will be first-time mothers, while others are having another child. Older mothers may be more financially stable or settled in their careers. They also may feel better able to care for a baby than a young mother would. But do older mothers and their babies face additional risks?
What to Watch For
Women who become pregnant in their 30s and early 40s can have safe, healthy pregnancies, says Ellie Ragsdale, MD, director of fetal intervention at UH Cleveland Medical Center. But they do face a higher risk of some problems. She mentions three areas that women should be aware of:
- Trouble conceiving: Starting in their early 30s, women become less fertile, and it may take them longer to get pregnant.
- Complications during pregnancy: Women older than age 35 have a higher risk for diabetes and high blood pressure during pregnancy.
Older women are also more likely to be pregnant with multiples. - Complications during delivery: Women in their 30s are more likely to need a cesarean section than younger women. Women who have their first baby after age 35 are also at increased risk for other delivery complications, such prolonged labor.
How does a mother’s age affect her baby? “Babies born to older mothers may have a higher risk for chromosomal birth defects, prematurity, and low birth weight,” Dr. Ragsdale says.
Plan for Good Prenatal Care
Keep in mind that women older than age 35 can have successful pregnancies and deliveries. Advances in medical care for both mother and baby can help prevent and treat many of the risks they face.
“Early and regular prenatal care is key to having a healthy baby at any age,” Dr. Ragsdale says. “It’s important to make sure you’re in good health before and during your pregnancy. Eat a nutritious diet and exercise regularly.
Avoid cigarettes and alcohol, which can harm the baby.”
In addition, Dr. Ragsdale advises taking 400 mcg of folic acid every day before and during pregnancy to help reduce the risk of birth defects. For women who have type 1 or type 2 diabetes, the American Diabetes Association recommends taking low-dose aspirin starting at the end of the first trimester to lower the risk for preeclampsia. Talk with your health care provider to determine your exact dose and frequency.
“Discuss any pregnancy plans with your provider, who can identify any special needs you may have and help make suggestions. Together, you can make pregnancy and motherhood wonderful experiences,” Dr. Ragsdale says.
Related Links
At University Hospitals, our maternal fetal medicine physicians are leaders in the field of high-risk pregnancy management. We provide seamless care for pregnant women, from the moment a condition is diagnosed, through the entire pregnancy, delivery and post-partum period.
Our priority is providing excellent care for both mother and baby, for a healthy pregnancy and safe delivery. Learn more about the high-risk pregnancy team at University Hospitals.
Childbirth after 30 - articles from the specialists of the clinic "Mother and Child"
Broitman Evgeniya Viktorovna
Reproductologist
Clinical Hospital "AVICENNA" GC "Mother and Child"
According to psychologists, the birth of a child at a more mature age is more favorable than in youth. As a rule, in a couple where parents are over 30, they prepare in advance for the appearance of the first child, and the child is born desired.
In addition, it is by the age of 30 that life experience, wisdom, and psychological maturity appear. All these qualities allow you to calmly relate to your condition, make informed decisions. Psychological comfort for the baby in such a family is provided.
The medical aspects of late pregnancy and childbirth have also improved in recent years.
Previously, there was an opinion that with increasing age, the number of possible complications of both pregnancy and childbirth increases in direct proportion.
However, in recent years this point of view has been refuted by most of the studies. The frequency of occurrence of such pathology of pregnancy as fetoplacental insufficiency (and as a result, intrauterine hypoxia and fetal growth retardation), as well as nephropathy of pregnant women occurs among women over 30 years of age with the same frequency as among younger pregnant women. Moreover, patients after 30 years of age, as a rule, are more disciplined and responsible, better follow the doctor's recommendations. This contributes to the prevention and timely treatment of emerging complications of pregnancy.
It is widely known that the incidence of diseases of internal organs, such as arterial hypertension, diabetes mellitus, obesity, metabolic syndrome, unfortunately increases after 30 years. However, the level of development of modern medicine allows timely diagnosis and treatment of such conditions at the stage of preparation for pregnancy and during it.
A necessary condition in such a situation is careful monitoring of the course of pregnancy, the state of internal organs. If necessary, the doctor prescribes treatment (both drug and non-drug), which does not adversely affect the baby's condition, and at the same time contributes to the normalization of the functions of the expectant mother's organs.
Women aged 35 years and older have a significantly increased risk of having children with a genetic disorder (eg Down syndrome, Edwards syndrome, Patau syndrome, etc.). However, at the present stage of development of medical genetics, most of these diseases can be diagnosed even in the early stages of pregnancy.
Already at 11-12 weeks of pregnancy, ultrasound examination can reveal some malformations and reveal changes that may indicate the presence of a chromosomal pathology of the fetus.
So, the presence of a thickening of the collar zone in the fetus at 11 - 12 weeks of pregnancy in most cases reveals Down's syndrome.
The second ultrasound examination is performed at 20-22 weeks of pregnancy. During these periods, it is possible to determine the anatomy of all organs of the fetus, to identify deviations in development.
Biochemical markers of chromosomal pathology are another important method for diagnosing genetic diseases. They are determined in the blood of the expectant mother at 11-12 weeks and at 16-20 weeks of pregnancy.
In the 1st trimester, the concentration in the blood of a protein associated with pregnancy and human chorionic gonadotropin is monitored, in the second trimester - a combination of alphafetoprotein and human chorionic gonadotropin. To make sure that the suspicions are correct, so-called invasive diagnostic methods are used.
This is a chorion biopsy (obtaining cells from the future placenta), which is performed at 8-12 weeks of pregnancy, amniocentesis (aspiration of amniotic fluid at 16-24 weeks), cordocentesis - puncture of the umbilical cord of the fetus (performed at 22-25 weeks of pregnancy).
These methods allow you to accurately determine the chromosome set of the unborn child and speak with confidence about the presence or absence of genetic diseases in him. All studies are carried out under ultrasound control, which allows you to minimize the degree of complications.
It was previously believed that the first birth after the age of 30 years is an indication for caesarean section. Now this position is hopelessly outdated. Most women of mature age give birth on their own. Of course, it should be remembered that in patients of this age category, such complications of childbirth as the development of weakness in labor, acute fetal hypoxia are somewhat more common than in the general population.
In such situations, the doctor in charge of the birth may decide to have an emergency operation. But almost all women who give birth to their first child after 30 years have a chance to give birth on their own.
For a successful course of pregnancy and childbirth, it is more important than for young mothers to monitor their health, carefully follow all the doctor's recommendations.
It is also desirable that pregnancy and childbirth be conducted by one doctor who knows in detail all the features of the course of pregnancy and can foresee possible complications of childbirth and prevent them in a timely manner.
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to the doctor - Broitman Evgenia Viktorovna
Clinical Hospital "AVICENNA" Group of Companies "Mother and Child"
Analysis of the binding of spermatozoa with hyaluronic acid (HBA-test)Spermogram analysis and other ejaculate studies and surrogate motherhoodEgg donationFemale infertilityICSIMSIFor out-of-town patientsFor out-of-town patientsArtificial (intrauterine) inseminationHow to become a sperm donor? How to become an egg donor? When is IVF contraindicated? to the IVF program at the expense of compulsory medical insuranceList of examinations before IIList of examinations before IVFIndications for PGDPreimplantation genetic diagnosisPreservation of fertilityOvulation stimulationSurrogacySurgical treatment of infertilityCenter for innovative reproductive technologies0003
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Pregnancy after 35 years: how to properly prepare?
In today's world, pregnancy after the age of 35 is regarded as a common situation and is becoming more common every year.
This is due to the fact that women first build a career and only then think about the birth of their first child. A second child after 35 years is also common, often in families the oldest child has already reached adolescence when he has a brother or sister. Every woman needs to know about the features, possible risks, planning and proper preparation for pregnancy after 35 years.
What are the difficulties of pregnancy after 35?
Fertility (ability to bear children) is an indicator that gradually decreases with age. Usually, fertility begins to decline after 30-32 years, depending on the characteristics of the woman's body. However, this does not mean that after 30-35 years, a physiological first pregnancy without any complications is impossible.
Average dependence of fertility on the woman's age
| Age | Probability of conception during the year |
| 25 years old | 87. |
| 30 years old | 83.9% |
| 35 years old | 73.3% |
| 40 years old | 49.4% |
5%
After the age of 35, a woman may have difficulty conceiving. It is important to remember that the age of a man also affects the likelihood of conception and intrauterine development of the fetus. Therefore, if any problems arise, both partners need to undergo a comprehensive medical examination.
With regular sexual activity without the use of contraception in healthy men and women over 35 years of age, the chances of conception within 12 months remain quite high.
How to properly prepare?
Proper preparation is the key to a happy and healthy pregnancy after 35. Women at this age are already balanced about procreation, and some are planning to give birth to a second or third child.
Preparing for the upcoming pregnancy is necessary for both a woman and a man.
How to prepare for pregnancy after 35:
- Lead a healthy lifestyle, give up bad habits. A balanced diet, regular exercise, quitting smoking and drinking alcohol - all this is necessary for the body to restore its internal resources and be ready for gestation and childbirth.
- Take folic acid 3 months (there are contraindications, you should consult your doctor) before the expected pregnancy. This substance is necessary for the normal formation of the fetal nervous system, and additional intake is especially important for women over 35 years of age.
- Find a qualified gynecologist or reproductologist (this is a doctor who deals specifically with the issues of conception and gestation) with experience in managing pregnant women over 35 years old. It is important that the doctor understands the possible risks of such a pregnancy, but at the same time does not exaggerate and does everything possible for the natural course of pregnancy and childbirth.
He will help in planning pregnancy, conduct an examination, prescribe a competent treatment for existing gynecological diseases. - Undergo a general physical examination. Every woman planning childbirth after 35 should consult a therapist, take a general and biochemical blood test, a general urine test, as well as examine the mammary glands and check thyroid hormones.
- Screen for sexually transmitted infections. Many infections have a chronic course and practically do not manifest themselves in any way, but they can prevent the conception and bearing of a child. Both partners should be screened for such infections. It is also advisable to be examined for viral hepatitis and to know your HIV status.
- Visit genetics. After 30 years, the risk of various chromosomal abnormalities and genetic defects in the fetus increases. Therefore, the couple should always consult with a geneticist, if necessary, take tests.
A positive attitude and a stable psycho-emotional state of future parents are very important, therefore, in some cases (especially if there are problems with conception), a couple is recommended to work with a psychologist.
What are the risks?
With age, each person develops various chronic diseases, as well as the endurance and ability of the body to recover.
The hormonal background also changes after the age of 35, which carries certain risks:
- In women who become pregnant after 35, the risks of negative effects of pregnancy on the cardiovascular system increase. This is manifested by an increase in blood pressure, a deterioration in the condition of the walls of blood vessels (in women who gave birth after 40 years, the risk of strokes in the future increased).
- Increased risk of preterm birth, spontaneous abortion and fetal death. It is important to have regular check-ups and if you have any concerns, see a doctor right away.
- Increased risk of developing gestational diabetes. During pregnancy, it is advisable to limit the intake of added sugar and switch to a predominantly plant-protein diet.
- Increased risk of chromosomal abnormalities in a child.
After the age of 35, the chances of giving birth to a child with Down syndrome and other genetic abnormalities are higher, since the genetic material of the mother and father accumulates mutations with age.
Although these risks exist, with the right approach, pregnancy and the birth of a healthy child after 35 years of age is confirmed by many women and doctors.
Reviews of doctors and patients about pregnancy after 35
The fact that childbirth and pregnancy after 35 is not always a difficult test is confirmed by numerous reviews:
It's never too late to become a mother." Irina, 37 years old
"Pregnancy with my second son after 35 years was more difficult for me than the first one. But the child was born healthy, and I recovered fairly quickly after childbirth." Anna, 36 years old
"I always treat pregnancy after 35 with great attention, patients undergo all the necessary screenings.
