Pregnancy
at a Later Age
Define "A
Later Age"
Women who become pregnant when they
are 45 or older are considered to be above the "normal" age range of pregnant
women. However, the "normal" age range is in the process of changing now,
as more and more women are opting to get their careers going before they
try to start a family.
The Risks
If one looks at the raw statistics,
the rates of many of the complications of pregnancy go up in older women.
Preeclampsia (a common pregnancy syndrome, characterized by high blood
pressure), premature delivery, maternal, fetal, and newborn death, and
placenta previa (the incorrect placement of the placenta inside the uterus)
are more common, to name a few.
From a practical perspective, there
is more than overall statistics to look at. First, the rates of most complications
are rather low. Therefore, an increase may not be much to get all worked
up about. Even an increase double or triple the rate of the 25 year old
population still means the absolute risk is low. For example, if the rate
of something is one in a million at 25, and the risk is (gasp) ten times
that at 45, then the risk is one out of 100,000. Not something to loose
sleep over. Secondly, the reason more older women have complications during
pregnancy is not all due to age. It is closely related to the increased
rates of complications and diseases and problems as we age. Older women
are simply more likely to have a medical problem to begin with. Pregnancy
is a major strain on the heart and blood vessels, and in turn, on all the
organs in the body. Nearly any pre-existing condition will be worsened
during pregnancy and make a more difficult pregnancy.
Like many age-related correlations
in medicine, the risk depends on things that happen to us over time, not
just age itself. Older mothers are more likely to have had other children.
Some of the complications, like the placement of the placenta over the
cervix, are more likely in women who have had many prior pregnancies. An
older mom is one who has had more time to have had gynecological procedures,
problems, and diseases that may change her organs in ways that make complications
more likely. Older women tend to release more than one egg a month, leading
to higher rates of twins. Twin pregnancies increase the risk of complications,
in younger and older moms. In short, it is more important to look at the
woman's medical history, and the pregnancy itself, rather than at the woman's
age.
Most importantly, is the practical
significance even if one has a complication. With good pre-natal care and
appropriate medical intervention, most complications can be corrected.
Most pregnancies will end with a healthy baby.
Some critics discourage older women
from having kids, because they may die before the children are grown. With
increased life expectancies today, you are more likely to live until this
child reaches adulthood, than a 25 year old mom was, a century ago.
Talk to Your
Doctor
You should plan ahead when starting
a family. Talk to your doctor about your specific health status to determine
if your high-risk status would be merely due to your age or if there would
be other complicating factors.
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