Are you considering pregnancy after 35? Understand the issues for older mothers — and know what it takes to have a healthy pregnancy.
By Mayo Clinic Staff
If you're older than 35 and hoping to get pregnant, you're in good company. Many women are delaying pregnancy well into their 30s and beyond — and delivering healthy babies. Taking special care can help give your baby the best start.
The biological clock is a fact of life, but there's nothing magical about age 35. It's simply an age at which various risks become discussion worthy. For example:
- It might take longer to get pregnant. You're born with a limited number of eggs. As you reach your early 30s, your eggs might decline in quality — and you might ovulate less frequently, even if you're still having regular periods. An older woman's eggs also aren't fertilized as easily as a younger woman's eggs. Does this mean you can't get pregnant? Of course not. It might simply take longer. If you're older than 35 and haven't been able to conceive for six months, consider asking your health care provider for advice.
- You're more likely to have a multiple pregnancy. The chance of having twins increases with age. The use of assisted reproductive technologies — such as in vitro fertilization — also can play a role. Since these procedures typically enhance ovulation, they're more likely to result in twins or other multiples.
- You're more likely to develop gestational diabetes. This type of diabetes occurs only during pregnancy, and it's more common as women get older. Tight control of blood sugar through diet, physical activity and other lifestyle measures is essential. Sometimes medication is needed as well. Left untreated, gestational diabetes can cause a baby to grow too large — which increases the risk of injuries during delivery.
- You're more likely to develop high blood pressure during pregnancy. Some studies suggest that high blood pressure that develops during pregnancy — before 20 weeks (chronic hypertension), after 20 weeks (gestational hypertension) or after 20 weeks and accompanied by protein in the urine (preeclampsia) — might be more common in older women. Your health care provider will carefully monitor your blood pressure and your baby's growth and development. You might need to take medication or deliver your baby before your due date to avoid complications.
- You might need a C-section. Older mothers have a higher risk of pregnancy-related complications that might lead to a C-section delivery, such as placenta previa — a condition in which the placenta blocks the cervix. Labor problems tend to be more common in first-time mothers older than 35.
- The risk of chromosome abnormalities is higher. Babies born to older mothers have a higher risk of certain chromosome problems, such as Down syndrome.
- The risk of miscarriage is higher. The risk of miscarriage also increases as you get older, perhaps due to the higher likelihood of chromosomal abnormalities.
The age of your baby's biological father also can pose risks. Men might experience a decline in fertility starting in their late 30s. Some research suggests that children born to men 40 and older have a higher risk of autism than do children of men younger than 30. A 2010 study also suggests an increased risk of autism in children born to a couple in which the father is older than 40 and the mother is younger than 30. Further research is needed, however. Men older than 50 are more likely to have babies with certain birth defects, such as the bone growth disorder achondroplasia, due to age-related genetic mutations. The risk of cognitive impairment also might be higher for children of older fathers. In a 2009 study, children born to older men scored slightly lower on tests measuring concentration, memory, reading and reasoning skills through age 7.
Taking good care of yourself is the best way to take care of your baby. Pay special attention to the basics:
- Make a preconception appointment. Meet with your health care provider before you conceive to make sure your body is prepared for the task ahead. He or she will assess your overall health and discuss lifestyle changes that might improve your chances for a healthy pregnancy and baby. The preconception appointment is a great time to address any concerns you might have about fertility or pregnancy at your age. Ask about the best ways to boost the odds of conception — and options if you have trouble conceiving.
- Seek regular prenatal care. During pregnancy, regular prenatal visits help your health care provider monitor your health and your baby's health. Mention any signs or symptoms that concern you, even if they seem silly or unimportant. Talking to your health care provider is likely to put your mind at ease.
- Eat a healthy diet. During pregnancy, you'll need more folic acid, calcium, iron, protein and other essential nutrients. If you're already eating a healthy diet, keep it up. A daily prenatal vitamin — ideally starting a few months before conception — can help fill any gaps.
- Gain weight wisely. Gaining the right amount of weight can support your baby's health — and make it easier to shed the extra pounds after delivery. A weight gain of 25 to 35 pounds (about 11 to 16 kilograms) is often recommended for women who have a healthy weight before pregnancy. If you're overweight before you conceive, you might need to gain less weight. If you're carrying twins or triplets, you might need to gain more weight. Work with your health care provider to determine what's right for you.
- Stay physically active. Unless your health care provider says otherwise, pregnancy can be a great time to get active. Regular physical activity can help ease or even prevent discomfort, boost your energy level and improve your overall health. Perhaps best of all, it can help you prepare for labor and childbirth by increasing your stamina and muscle strength. Get your health care provider's OK before starting or continuing an exercise program, especially if you have any underlying conditions.
- Avoid risky substances. Alcohol, tobacco and illicit drugs are off-limits during pregnancy. Clear any medications or supplements with your health care provider ahead of time.
- Learn about prenatal testing for chromosomal abnormalities. Diagnostic tests such as chorionic villus sampling and amniocentesis provide information about your baby's chromosomes or the risk of specific chromosomal abnormalities, but also carry a slight risk of miscarriage. Your health care provider can help you weigh this risk against the value you place in knowing the test results. Although most prenatal tests simply confirm that a baby is healthy, it's important to prepare for other possibilities.
The choices you make now — even before conception — can have a lasting effect on your baby. Think of pregnancy as an opportunity to nurture your baby and prepare for the exciting changes ahead.
Jul. 23, 2011
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