Getting Pregnant in Later Years

If you are 35 or older, you and your baby may be at an increased risk for problems. Most older women who are in good health will not have problems during pregnancy. But there is an increased risk of complications. A pregnancy can trigger or worsen high blood pressure, heart disease, or kidney disease. Older women also have a higher risk of miscarriage and stillbirth.

Women with complicated pregnancies may have to deliver their babies early. Or they may have babies that are small. The biggest risk for women ages 35 or older is Down syndrome. This is a type of genetic abnormality in the baby. If 1,000 33-year-old women are tested, four of them will have a baby with abnormal chromosomes. If 1,000 40-year-old women are tested, 15 will have a baby with a chromosome problem. The risk continues to rise as women get older.

This increased risk is found in all older mothers regardless of race, ethnicity, and socioeconomic status. If you will be older than 35 when your baby is born, you should be offered:

• Genetic counseling and, if desired, prenatal diagnosis by first trimester (nuchal translucency and maternal serum)
• And/or sequential screening tests, chorionic villus sampling, amniocentesis, or non-invasive prenatal testing

Nowadays, many women younger than 35 years will also choose to have genetic testing in pregnancy.

It's also more difficult to get pregnant when you are older. The chance of getting pregnant in a given month decreases as you get older, and your risk of miscarriage rises after age 35. If you are older than 35 and have been trying to get pregnant for more than six months, you should talk to your health care provider about fertility treatments.

The bottom line: if you are older than 35 and want to have a baby, you should go for it but recognize you may be facing a somewhat bumpier road than you might have 10 years earlier.

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