HealthONE - December 13, 2017

For many reasons, women today may choose to delay pregnancy until later in life. Along with increased focus on career, finances and late marriage, doctors are now able to treat women over the age of 40 who may have previously been infertile. In fact, a woman over the age of 60 has reportedly delivered a healthy baby, raising complex ethical, social and medical concerns. For women over the age of 40 who choose to start a family or add to one, pregnancy carries risks to both mother and baby. Learn more about high-risk pregnancy and how to have a healthy pregnancy in this age group.

While it's possible to have a healthy pregnancy later in life, older mothers are at an increased risk for maternal illnesses, medical issues that affect the fetus, genetic defects, pregnancy loss, and labor and delivery complications. While increased risk of complications can occur as soon as age 35, proper women's health before pregnancy and obstetrics care during pregnancy can help ensure a healthy outcome.

Maternal illnesses

Conditions like diabetes, high blood pressure and thyroid disorders occur more frequently in pregnant women over 40 and may not appear until a woman is pregnant. Fortunately, these conditions can be managed with proper care and may even go away after the baby is born. Many illnesses that are not related to pregnancy can be screened for, diagnosed and treated in advance to help improve the chances of a healthy pregnancy and baby. Maternal illnesses can negatively affect the fetus if not treated properly, but early prenatal care can significantly lower these risks.

Genetic defects

As a woman ages, more of her eggs have chromosomal abnormalities, so the risk of having a child with a genetic defect increases with maternal age. In the case of Down syndrome, likelihood increases from nearly 1 in 700 in the general population to 1 in 353 at the age of 35. This number increases to 1 in 85 by the age of 40 and up to 1 in 35 at the age of 45. Ask your OB/GYN about genetic counseling if you're worried about the risk of genetic defects or have a family history because certain tests can help identify these types of problems before getting pregnant.

Pregnancy loss

Pregnancy loss often occurs in the first trimester and is frequently due to genetic abnormalities of the fetus. Risk of miscarriage increases with previous miscarriages and also with age. Miscarriage risk is 20 percent for women at 35 and climbs to 80 percent when a woman reaches 45 years.

Labor and delivery complications

Labor and delivery complications that increase for women over age 40 include premature labor, premature birth, abnormal placement of the placenta, increased prenatal blood pressure and fetal distress.

Lowering the risks

While some high-risk pregnancy complications are unavoidable, you can reduce your risk. Contact your OB/GYN, before you get pregnant if possible, to review your medical history, as well as diagnose and treat any disorders that might otherwise go undetected. Additionally, take care of yourself by quitting smoking, avoiding alcohol, eating a well-balanced diet, starting a prenatal vitamin and exercising regularly.

Learn more about High-Risk Pregnancy Care.