Pregnancies after the age of 35 are becoming increasingly common in the United States, and therefore, it is becoming extremely important to understand the increased risks and complications that pregnancy after 35 entails (Mayo Clinic Staff, 2017.) These problems exist even before conception. A woman doesn’t have an unlimited supply of eggs, and as she ages, the quantity and quality of her egg supply decreases, and it becomes more difficult for the eggs she does produce to be fertilized (Mayo Clinic Staff, 2017). The hormonal changes that occur later in life also mean that it is more likely for a woman to release multiple eggs at once, increasing the chance of twins (Mayo Clinic Staff, 2017). Once pregnant, a woman over 35 faces an increased risk for numerous medical problems. These health problems include gestational diabetes and high blood pressure (“Risks of Pregnancy Over Age 30,” n.d.). In some pregnancies, high blood pressure is caused by preeclampsia, a complication that can also include liver or kidney damage, indicated by excess protein in the urine (Mayo Clinic Staff, 2018). In addition to these health problems, the risk for a difficult labor or a loss of pregnancy also increases (Mayo Clinic, 2017).
The risks of a later pregnancy aren’t just limited to the mother. The child also faces the possibility of significant health risks. If the mother is diagnosed with gestational diabetes or preeclampsia during her pregnancy, the child is at risk of fetal growth restriction, premature birth, or a low birth weight (Mayo Clinic, 2017). Another significant risk the child faces is an increased chance of birth defects, which are often caused by genetic abnormalities (“Risks of Pregnancy Over Age 30,” n.d.). One of the most common chromosomal abnormalities is Down syndrome, or trisomy 21, which occurs when a child has 3 copies of chromosome 21, instead of 2 copies (“Chromosome Abnormalities Fact Sheet,” 2019). Characteristics of Down syndrome include low muscle tone, short height, a small head, and intellectual disabilities (“Chromosome Abnormalities Fact Sheet,” 2019). At the age of 25, the risk of a woman having a child with Down Syndrome in 1 in 1,250, but this risk increases to 1 in 100 for a woman pregnant over 40 (“Risks of Pregnancy Over Age 30,” n.d.). Another genetic abnormality that is related to maternal age is Klinefelter syndrome, in which a male is born with an additional X chromosome (Mayo Clinic Staff, 2019). Characteristics of Klinefelter syndrome include reduced muscle mass, reduced testosterone production, and reduced body and facial hair (Mayo Clinic Staff, 2019). In females, if an individual is born lacking an X chromosome, they are diagnosed with Turner syndrome. Effects of this genetic abnormality often include a below average height and infertility (“Chromosome Abnormalities Fact Sheet,” 2019).
Although there are an increasing number of pregnancies in women over the age of 35, different tests and technologies have been developed to help detect many of the risks associated with an older pregnancy. In terms of detecting chromosomal abnormalities, a prenatal cell-free DNA test can be performed by analyzing the mother and the fetus’s DNA from a maternal blood sample (Mayo Clinic Staff, 2017). Other tests such as a chorionic villus sampling, which analyzes a tissue sample from around the baby, or an amniocentesis, which analyzes a sample of amniotic fluid, can also be performed to detect genetic disorders in the fetus (“Risks of Pregnancy Over Age 30,” n.d.). However, these tests do have a slight risk of causing a miscarriage (Mayo Clinic Staff, 2017). In terms of fertility, women over the age of 35 who are having difficulty conceiving can try in vitro fertilization (IVF), in which the egg is fertilized by sperm in a petri dish, then transferred to the mother’s uterus (Gurevich, 2020). While the success rate of this procedure does decrease with age, it is still successful in women over the age of 35 and can offer another option if they are struggling with conception (Gurevich, 2020).
With all of the risks and complications associated with pregnancy after 35, why is the rate of women in their 30’s increasing? The primary reason is the increase of women receiving a college degree. Instead of having a baby, women are using their 20’s to finish school and build a career, often waiting until they are more financially stable to have a child (Bui & Miller, 2018). Socioeconomic status also plays a role in when a woman has her first child. Women of a lower socioeconomic status are less likely to be able to afford a college education or even birth control. After graduating high school, instead of going to college, these women are more likely to start a family (Bui & Miller, 2018).
Personally, I am not opposed to having a child after the age of 35. My education, career and overall well-being are extremely important to me, and I want to make sure I am at a very stable point in my life before I have children. Furthermore, I want to have the financial stability needed to provide an enriching life for a child. I don’t know at exactly what age this will be, but with the genetic testing and fertility treatments that currently exist, I hope to have the medical support I need to have a baby after 35, if need be.
References:
Chromosome Abnormalities Fact Sheet. (2019, November 7). National Human Genome Research Institute. https://www.genome.gov/about-genomics/fact-sheets/Chromosome-Abnormalities-Fact-Sheet
Gurevich, R. (2020, January 19). Overview and Help for Getting Pregnant After 35. Verywell Family. https://www.verywellfamily.com/what-are-your-chances-of-getting-pregnant-after-35-1959931
Mayo Clinic Staff. (2017, August 5). Pregnancy after 35: Healthy moms, healthy babies. Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/pregnancy/art-20045756
Mayo Clinic Staff. (2018, November 16). Preeclampsia. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/preeclampsia/symptoms-causes/syc-20355745?page=0&citems=10
Mayo Clinic Staff. (2019, September 21). Klinefelter syndrome. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/klinefelter-syndrome/symptoms-causes/syc-20353949
Risk of Pregnancy Over Age 30. (n.d.) University of Rochester Medical Center. https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=90&ContentID=P02481
Quoctrung, B., & Miller, C.C. (2018, August 4). The Age That Women Have Babies: How a Gap Divides America. The New York Times. https://www.nytimes.com/interactive/2018/08/04/upshot/up-birth-age-gap.html