Pregnancy and you blog

How old is too old to have a baby?

By Mary M. Murry, R.N., C.N.M. March 27, 2008

When I had my first child I was 32 years old and considered an "elderly primip." I felt I was in the prime of life, certainly not elderly.

About 14 percent of births in the United States are to women 35 and older. Now they are considered advanced maternal age. What does that mean exactly?

I thought I would tackle the issues of advanced maternal age in two parts. Today I will talk about conception and early pregnancy. I will cover more of the possible issues of late pregnancy in women over 35 if you are interested. My goal is not to make light of the potential issues but rather put them in perspective.

Women over 35 may take longer to be able to conceive. This is related to those eggs we have had since birth. We don't make new eggs as men make new sperm. Our eggs are with us almost from conception. They don't always age well. They can lose quality and there can be fewer of them. This is one reason to seek help from your health care provider if you have been unable to achieve pregnancy after trying for 6 months.

There is an increase in spontaneous miscarriage with an approximate risk of 25 percent in women age 35-39 and 51 percent in women 40-44. If you look at this another way, women 35-39 have a 75 percent chance of not having a miscarriage.

The concern many women over 35 hear about most often is Down Syndrome or other chromosomal abnormalities. At 35 a woman's risk of any clinically significant chromosome abnormalities is about 1 in 200. Her risk of a baby with Down Syndrome is about 1 in 365. In other words, the odds of having an absolutely normal baby would be about 99.34 percent.

I haven't answered the question of how old is too old because I don't think there is one answer. There are so many positive things about having children when we are older and yet the increased risks are real. Learn as much as possible and if and when you get pregnant, rejoice!

March 27, 2008