Pregnancy at a later age: what women should know

Many women choose to delay pregnancy until after age 35. In fact, according to the National Center for Health Statistics, nine times as many first births to women over the age of 35 were reported in 2012 than four decades ago. In 2014, 11 per 1,000 pregnancies were attributed to women ages 35 to 39, versus only 2 per 1,000 pregnancies in 1970.

"While more women are delaying childbearing until after age 35, it is important for women to consider certain risks involved with having a baby at a later age," says Dr. Amy French, a board-certified OBGYN affiliated with Sharp Grossmont Hospital. "Understanding these issues and knowing what steps to take is important in order to have a healthy pregnancy."

Consider the risks
In general, once a woman turns 35, the frequency of certain problems increases:

• Fertility issues. A woman's quantity and quality of eggs can decrease over time, making it more difficult for women to get pregnant as they get older.

• High blood pressure or gestational diabetes. These health conditions may occur specifically during pregnancy and are more common as women get older.

• Chromosome abnormalities. These issues are more likely to occur in babies born to older women. Down syndrome is one example of a chromosome abnormality.

• Miscarriage. The risk of miscarriage also increases. This is thought to be due to the increased risk of chromosome abnormalities. Many pregnancies with chromosome abnormalities end in miscarriage.

• Cesarean section (C-section). The frequency of pregnancy complications is higher for older mothers, which may increase risk of cesarean delivery. Additionally, as a woman's number of pregnancies increases, the frequency of placenta previa - blockage of the birth canal by the placenta - increases, which may also raise the risk of cesarean delivery.

Pre-pregnancy steps to take
Staying healthy before and during pregnancy is an important step that women of any age can take for themselves and their baby. "All women thinking of becoming pregnant should work toward optimal health, including weight management and optimizing management of chronic conditions," says Dr. Craig Saffer, a board-certified OBGYN affiliated with Sharp Mary Birch Hospital for Women & Newborns. "But this is especially true for women over age 35."

For women who are planning to get pregnant, consider the following tips:

• Attend regular preconception and prenatal doctor visits. Even before becoming pregnant, women are encouraged to get a health assessment from their doctor, who can make recommendations to help increase the chances of a successful and healthy pregnancy. Regular prenatal visits can help in monitoring the health of both mother and baby.

• Maintain a healthy diet. Eating foods rich in nutrients, such as folic acid, iron, calcium and protein, is important before and during pregnancy. Taking prenatal vitamins daily, beginning a few months prior to conception or earlier, is a great way to start.

• Monitor your body weight. Achieving normal body weight before conception and maintaining normal weight gain during pregnancy go a long way to preventing pregnancy complications, such as diabetes, high blood pressure and cesarean delivery.

• Keep up physical activity. Exercise can help pregnant women maintain a good energy level, boost their comfort level and maintain overall health. Any exercise program should be discussed with a doctor prior to starting.

• Avoid smoking and alcohol. These activities increase the risk of health problems for both mother and her developing fetus.

In addition, prenatal testing is an option for women who want to assess their pregnancy. Diagnostic tests, such as maternal blood tests, chorionic villus and amniocentesis, help detect chromosome abnormalities in a developing fetus. There can be risks associated with these tests, so women should talk to their doctor in order to weigh the benefits and risks.

"For women contemplating pregnancy, this is an exciting time, regardless of age," says Dr. French. "By taking the proper steps to prepare, women will increase the opportunity of having a successful and healthy pregnancy."

Learn more by attending one of our upcoming pregnancy and childbirth classes.