Advanced Maternal Age

“Advanced maternal age” is a term that describes anyone who is 35 or older and pregnant. This is the age when your chances of pregnancy complications increase. Some of these complications are higher rates of miscarriage and a greater chance of having a baby with a genetic disorder. Advanced maternal age is the newer and preferred name for a geriatric pregnancy.

Pregnancy care providers don’t treat pregnancy after 35 much differently than typical pregnancy. It’s mostly a label that means “keep an eye out” because they know your risk of complications is slightly higher.

Despite this, you can have a healthy pregnancy and a healthy baby after 35. Attending all of your prenatal check-ups and tests is more important than ever. This is how your pregnancy care provider can identify and treat potential problems as soon as possible.

What are the risks of having a baby after 35?

Many women over 35 have healthy pregnancies and babies. But there is a greater risk of certain complications and health conditions. Some of those are:

• High blood pressure
• Preeclampsia
• Gestational diabetes
• Multiple pregnancy
• Preterm birth or low birth weight
• Large baby
• Having a baby with Down syndrome or other genetic disorders
• Miscarriage or stillbirth
• Needing a c-section delivery

Remember, these are just risks. Your overall health, access to prenatal care and lifestyle habits also play a huge role in your pregnancy.

Why are there more complications if you’re over 35 and pregnant?

The quality of your eggs declines as you age. This means that as your age goes up, your egg quality goes down. “Older” eggs are more likely to produce a baby with chromosomal anomalies. While these risks are still low, they increase with age. Prenatal screening tests in the first trimester check for many of these chromosomal anomalies.

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. For example, even a woman who isn’t pregnant is more likely to have high blood pressure at age 38 than at 28. These chronic medical conditions can affect pregnancy and delivery.

Most complications increase as you get older, with most occurring after 40.

What tests are recommended for an advanced maternal age pregnancy?

Pregnancy care providers usually recommend prenatal genetic testing for women of advanced maternal age. These screenings can detect if your baby is at a higher risk for certain congenital or chromosomal conditions (present at birth).

Most tests use a blood sample, an ultrasound or both. Blood tests look for certain substances in your blood that may indicate a congenital condition. Ultrasounds look at measurements like nuchal translucency, which can be a sign of Down syndrome or other chromosomal conditions.

Remember, these tests are screenings, meaning they detect the possibility of a genetic condition.

If your provider detects an abnormality on a screening test, they’ll recommend diagnostic tests, like:

• Chorionic villus sampling. In this test, your healthcare provider collects a sample of cells called villi from the placenta. These cells usually contain the same genetic makeup as the fetus.
• Amniocentesis. In this procedure, your provider places a needle through your abdomen to remove amniotic fluid from your uterus. This fluid can help diagnose certain genetic conditions.

Pregnancy care providers may recommend that pregnant women over 35 have more frequent ultrasounds, an earlier gestational diabetes screening or more regular monitoring for preeclampsia.

How is an advanced maternal age pregnancy treated?

Healthcare providers typically don’t treat you differently just because of your age. But if genetic tests indicate your baby may have a congenital or chromosomal disorder or you have a condition like gestational diabetes, your provider will take precautions to keep you safe. They may refer you to a maternal-fetal medicine specialist. This is someone who specializes in higher-risk pregnancies. Other times, you may just need more frequent prenatal visits with your obstetrician to check on the fetus’s growth and well-being.

With advances in medical care and technology, most pregnancies in women over 35 are healthy and result in a healthy baby.

Can I lower my risk of pregnancy complications if I’m older than 35?

If you’re 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:

• Make sure all of your preventive care is up to date.
• Manage any existing medical conditions.
• Take a prenatal vitamin.
• Get at least 30 minutes of physical activity on most days.
• Quit smoking and/or using tobacco products.
• Stop drinking alcohol.
• Eat a healthy diet with plenty of fruits, vegetables, lean meats and whole grains.
• Stay within a healthy weight range during pregnancy.

What are my chances of miscarriage if I am over 35?

Your chances of having a healthy baby are still much higher than your chances of miscarriage. Your chances of miscarriage increase with age:

• 20 to 30 years old: 9% to 17% chance (approximately 9 to 17 per 100 people)
• 35 years old: 20% chance (or 1 in 5 people)
• 40 years old: 40% chance (or 4 in 10 people)
• 45 years old: 80% chance (or 8 in 10 people)

Your pregnancy care provider is the best person to discuss possible complications with.

What are the benefits of having a baby after 35?

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. This means people may delay starting or expanding their families. About 20% of women in the U.S. now have their first child after age 35.

What is the oldest age a woman can get pregnant naturally?

There isn’t one specific age. Having a healthy pregnancy is dependent on how healthy you are overall, not just how old you are.

But experts know that your chances of getting pregnant decline as you age. For example, by 40, your chance of getting pregnant naturally is about 10% each menstrual cycle. In your early 30s, your chances are around 25% each cycle.