Advanced Maternal Age: What Are the Risks?

As women across the board are pairing up later and “leaning in”, the average age of a woman giving birth for the first time in the US hit a record high in 2013. This reflects the number of women who are now waiting until 35 and beyond to get pregnant. However, we also know there are risks associated with advanced maternal age. So what exactly does this mean for you? Let’s take a look at what you should be aware of if you’re thinking of having a baby after 35.

When does “advanced maternal age” start?

Women’s fertility begins to decline after about 32, but “advanced maternal age” is usually defined as pregnancy after 35 years of age. This isn’t to say that you can’t get pregnant or have a healthy pregnancy after you hit 35, or that you’ve missed your chance to be a parent. However, there are some risks to think about realistically.

Advanced maternal age risk #1: Decreased fertility

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We often hear about “biological clocks” as if it’s only a lady-thing. In reality, the quality of both egg and sperm cells declines with age, making it harder for fertilization to occur – and when it comes to conceiving a healthy pregnancy in your late 30s and early 40s, it’s quality rather than the quantity that seems to make the most difference.

If you and your partner are in this age bracket and have been trying to conceive for more than 6 months without success, speak to your doctor. They should be able to work out what’s going on and discuss your options.

Advanced maternal age risk #2: Chromosomal abnormalities

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The odds of your child being born with a chromosomal abnormality increase with maternal age. This is because your supply of egg cells ages alongside you after your ovaries come online at puberty – unlike sperm cells, which are continuously replenished. The older you get, the more likely it is for there to be an error in the number of chromosomes (DNA strands) in the egg cells.

Chromosomal abnormalities are caused by these glitches in the child’s genes, and include congenital conditions such as Down Syndrome and Klinefelter Syndrome. The odds of a child being affected rise with the mother’s age. For example, the odds of giving birth to a child with Down Syndrome are 1 in 1300 at age 25, and the likelihood increases to 1 in 350 at age 35, and 1 in 55 at age 42.1

Advanced maternal age risk #3: Miscarriage and stillbirth

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Advanced maternal age can increase the risk of miscarriage and stillbirth. This is often a result of chromosomal abnormalities in the fetus, and is associated with a risk of hemorrhage and emergency Caesarean sections for the mother. The risk of miscarriage sits at about 10% for women in their 20s, but this rises to around 20% for mothers in their 40s. The risk of stillbirth also appears to be higher for older pregnant women, although the extent of this and precise mechanism still isn’t clear.

Advanced maternal age risk #4: Health risks to the mother

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The risks of advanced maternal age don’t just refer to the baby: it also brings some dangers for the mother. In particular, older moms are thought to be at increased risk for preeclampsia, a pregnancy complication marked by high blood pressure and protein in the urine (particularly if it’s a first-time pregnancy).

This can threaten both you and the baby’s health, and severe cases, this may require a Caesarean section. Rates of preeclampsia in the general population are usually just 3% to 4%, but the risk increases to up to 10% for women over 40, and up to 35% for women over 50.2

The incidence of gestational diabetes is also 3 to 4 times higher for older women, while maternal age over 35 is associated with at least a 4-fold higher risk of ectopic pregnancy. Older moms should also be aware of the risk for placental abruption. Generally occurring in only 1% of pregnancies, this is a potentially life-threatening condition when the placenta that connects the baby prematurely separates from the walls of the uterus.

Age isn’t a direct risk factor, but older women are more likely to be affected by conditions such as high blood pressure and preeclampsia, which can lead to the condition.

Don’t let advanced maternal age risks freak you out

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No-one likes to see the word “risk” and the word “pregnancy” in the same sentence. But the important thing to remember is this: it’s still possible to have a healthy pregnancy and birth after 35. While there are risks associated with later pregnancies, for the most part, they are relative – not absolute.

Many women make the call to delay pregnancy for the perfectly legitimate reasons of wanting to advance their careers, see the world, or because they just plain weren’t ready to or didn’t want to have a kid any earlier. Many obstetricians agree that with good prenatal care and a healthy lifestyle with a good diet, you’ll give yourself the best chance for a healthy pregnancy after 35.

The take-home message is this: don’t let yourself be too alarmed by the risks. Plenty of women can and do have healthy pregnancies after 35. In fact, pregnancy after 35 often means you’ve gotten a bit older and wiser, and statistics suggest that waiting to get pregnant means you’ll ultimately be in a better financial and social situation for raising a kid.

As long as you take care of health, think realistically about the risks, and touch base with your physician regularly about your best options, then you’re already off to a great start on your parenting journey.