ADVANCED MATERNAL AGE

 There is a demographic shift towards later childbearing, and it has become a major health concern. There are numerous associations between advanced maternal age and pregnancy complications. Many women are focusing on their careers and by the time they are on the right path they might have some time to deal with the harsh dating world to find the right man. I was extremely career-oriented in my twenties and felt like I could survive without a child. All I wanted was to be financially independent and not rely on any man to feed me. I immigrated in my late twenties and by the time I was settled in a specialization program, I was about 33 years old. By then I really wanted to settle and have a family. I got married at 35 years old and had a baby at the age of 37.

Women over 35 have decreased fertility which means it may take them a longer time to fall pregnant. They have higher rates of pregnancy failure, miscarriage, and ectopic pregnancy. This is mainly attributed to a progressive decrease in oocyte numbers and their quality. With all this, we also have an increased risk of chromosomal abnormalities such as trisomy 21(down syndrome), trisomy 13, and 18.

Older women are more likely to enter pregnancy with pre-existing hypertension which can cause morbidity in mom and fetus. Gestational hypertension and pre-eclampsia are also more common in this age group, especially if the women are primigravida, having the baby with a new partner or the spacing of the pregnancy is more than seven years. The guidelines suggest that women of advanced maternal age are screened for gestational diabetes at 24 weeks with the oral glucose tolerance test. It is important to counsel women with gestational diabetes and hypertension that even if the blood pressure and the blood sugar are within the normal range six weeks post-partum, they are at increased risk of becoming hypertensive or diabetic in the next five to ten years and they have to keep an eye on it.

The reasons for the underlying trend of older mothers are complex, but decisions about the timing of childbearing may often be dictated by factors beyond the women’s control. Despite all the various evidence for an overall increase in poor outcomes, the absolute numbers experiencing complications are small and most women over 35 have a straightforward pregnancy and birth. At present, there are no effective strategies to reduce the incidence of adverse outcomes such as stillbirth.





 

 

 

 

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