Advanced maternal age describes a pregnancy where the birthing person is older than 35. Pregnant people over age 35 are more at risk for complications like miscarriage, congenital disorders and high blood pressure. Screening tests can help detect certain congenital disorders.
Advanced maternal age is a medical term to describe people who are over age 35 during pregnancy. Pregnancies have an increased risk for certain complications when the birth parent is 35 or older. Some of these complications are higher rates of miscarriage, genetic disorders, and certain pregnancy complications like high blood pressure or gestational diabetes.
Advanced maternal age pregnancy isn't treated much differently than a typical pregnancy. Your healthcare provider may suggest prenatal testing and monitor you more closely. Being mindful of your pregnancy symptoms and staying healthy becomes even more important when you're over age 35 because your risk for chronic conditions increases.
Despite these risks, people can have healthy pregnancies and healthy babies after 35.
You're considered of advanced maternal age if you will be 35 or older at the time of your due date.
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Yes, they’re the same. Geriatric pregnancy is an outdated term and most healthcare providers prefer to use the term advanced maternal age.
Healthcare providers have discovered that the biggest decline in fertility happens in your mid-to-late 30s. A decline in fertility means the quality and quantity of eggs in your ovaries decreases. This doesn't mean getting pregnant after 35 is impossible (it's very possible). It means 35 is the age when fertility starts to decline more rapidly and your chances for complications increase more significantly.
You’re born with a set number of eggs. You release an egg at ovulation each menstrual cycle. The older you get, the fewer eggs you have. The eggs you do have are more likely to have chromosomal issues that lead to genetic disorders. A genetic disorder is a condition present at birth.
All pregnancies come with risks; however, you or your baby are at increased risk for the following conditions when you are of advanced maternal age:
Advanced maternal age is associated with a decrease in egg quality. This means that as your age goes up, your egg quality goes down. "Older" eggs are more likely to cause chromosomal anomalies. A lot of these chromosomal anomalies are what healthcare providers screen for in the first trimester.
Another reason there are more complications after 35 is that your chances of developing most chronic medical conditions increase as you age. Your body simply responds to these conditions differently once you are older. These chronic medical conditions can affect pregnancy and delivery. For example, even a nonpregnant person is more likely to have high blood pressure at 35 than at 25.
Starting a family is a personal decision, and many people choose to wait until later in life to have children. One of the benefits of having a baby later in life is having more life experience and financial stability. Couples are getting married later than they were decades ago. Assisted reproductive technologies (like in vitro fertilization or IVF) are getting more successful. This means people may delay starting or expanding their families. Studies show the rate of people having their first baby in their late 30s is rising every year.
Genetic screening tests are recommended for all pregnancies but are particularly important for people of advanced maternal age. These noninvasive screenings are optional and can detect if your baby is at high risk for certain congenital conditions. Most testing uses blood tests or ultrasound. These tests are screenings, meaning they detect the possibility of a genetic condition.
If a problem is detected in a screening test, invasive genetic testing can be done. These include chronic villus sampling (CVS) and amniocentesis. CVS uses cells from the placenta to diagnose a genetic condition. Amniocentesis involves placing a needle through your abdomen to extract amniotic fluid from inside the uterus. This fluid can help diagnose certain genetic conditions.
Not really. Healthcare providers typically don't treat you differently just because you are of advanced maternal age. However, if genetic screening tests indicate your baby may have a congenital disorder, your provider may refer you to a maternal-fetal medicine specialist. This is someone who specializes in higher-risk pregnancies. Other times you may have more frequent prenatal visits with your regular provider or have testing done sooner. For example, an earlier glucose screening test (to check for signs of gestational diabetes) or more ultrasounds or fetal heart rate monitoring to ensure that your baby is doing well. If you have other risk factors for preeclampsia, your doctor may recommend that you take a baby aspirin daily throughout most of your pregnancy to decrease your risk of developing this condition.
Your prenatal care is more important as you age just because your risks for certain conditions increases. So, it's more important than ever to attend all appointments or screenings, eat a healthy diet and maintain a healthy weight through your pregnancy.
If you are over 35 and pregnant (or think you will be), there may be some steps you can take now to lower your risk for pregnancy complications:
Your chances of having a healthy baby are still much higher than your chance of miscarriage. If you are between the ages of 35 and 40, your chance for miscarriage is about 20% to 30%. Rates start to rise significantly for people who are 40 and older as they continue to age.
You can take steps to increase your chances of having a healthy baby.
Some things you can do if you are older than 35 and pregnant are:
No, it's not too old to have a baby. The pregnancy rates of people having babies in their late 30s or 40s have increased across all races. Having a healthy pregnancy is dependent on how healthy you are overall, not just how old you are.
No, the chance of your baby having a congenital disorder is still small. However, as you get older, the risks of having a baby with a chromosomal disorder increase.
They’re more common as you get older. For example, if you are older than 35, your chances of having a child with Down syndrome increases. According to the American College of Obstetricians and Gynecologists, your chances are:
Yes, it's possible to get pregnant naturally if you're 42. However, by about age 40, your chances of getting pregnant naturally is about 5% each menstrual cycle.
No, once menopause has started, you can't reverse the process. If you are delaying pregnancy or are worried about preserving fertility, reproductive technologies like IVF or freezing your eggs are an option. Pregnancy using donor eggs is another option. Talk to your healthcare provider about these methods or if you believe you are entering menopause.
A note from Cleveland Clinic
Most pregnancies over the age of 35 are healthy and successful. However, it's important to know the potential complications with advanced-age pregnancies. Talk to your healthcare provider about what genetic screening tests they recommend or what you can do to stay healthy if you are older than 35. In most cases, age during pregnancy is just a number. If you maintain a healthy weight, manage any conditions you have and listen to your healthcare provider, you will likely deliver a healthy baby.
Last reviewed by a Cleveland Clinic medical professional on 02/28/2022.
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