Last modified: August 2, 2019
Richard Honaker M.D.View Full Profile
It has been the trend for a while now for women to have babies in their 30s instead of in their 20s. The question that needs to be answered is if older parenthood involves more risks with women’s health, pregnancy, and birth. According to the Centers for Disease Control and Prevention (CDC), birth rates among women aged 30-34 exceeded those women aged 25-29 in the US in 2016 and this is the first time this happened in thirty years.
Currently, the average age for women who are having their first child is 28 years of age. In 2015 it was 26.4 and in 2014 it was 26.3. Experts mostly focus on the average or mean maternal age because of the birth outcomes that are linked with the age of the mother like multiple births and congenital disabilities.
Studies have reported that people may postpone parenthood until 35 or older for many reasons.
These reasons consists of women achieving higher levels of education, establishing their career, enhanced contraceptive techniques, women’s health in general, social and cultural changes that made women feel like they’re not yet ready to have kids, lack of childcare, low benefit levels, rigid workplace policies, uncertain economic and housing provisions, unemployment, and improved fertility options like IVF.
Negative Pregnancy Terms for Women 35 and Older
There are some terms used for women over the age of 35 who are just having their first pregnancy. Terms include advanced maternal age (AMA), older mothers, elderly primigravida, and elderly primipara. These terms have negative undertones or implications for someone who is only 35 years old. Are these terms just mean or does pregnancy for women over the age of 35 have serious risks for pregnant women’s health and their babies?
Women have been giving birth to healthy babies throughout their 30s and beyond. Hitting the age of 35 simply means that specific risks deserve more discussion. These risks are likely to happen more the moment you reach the age of 35, but it doesn’t mean that they will have a noticeable impact on every woman in her mid-thirties and older. Here are some of the pregnancy risks on women’s health.
Women are born with eggs. As women age, the probability of entering pregnancy minimizes because of the decreasing number of remaining eggs and their diminished caliber. The same goes for men. Their fertility also declines as they age because of decreasing sperm counts, motility, and semen volume. If you combine these age-related factors, it will be more difficult for women to enter pregnancy.
A recent study published in The New England Journal of Medicine has found that out of all the women who had artificial insemination, 74% of them who were under 31 years old got pregnant within a year. This declined to 61% for those between the ages of 31 and 34, and it even diminished more to 54% for women who are already 35 and over. Women’s health in terms of fertility declines as a woman continues to age.
There are specific genetic risks that are present more frequently in pregnancy as women age. One example of this is that the rate of having a baby with Down syndrome increases with maternal age. At the age of 25, the rate of an embryo getting Down syndrome at the 10-week mark of pregnancy is 1 out of 1,064. This increases to 1 out of 686 at age 30 and 1 out of 240 at age 35. By the age of 40 years, it rises to 1 out of 53 and 1 out of 19 at age 45.
One study that was published in Nature Communications investigated why older mothers have greater risks of delivering babies with congenital anomalies that are distinguished by abnormal numbers of chromosomes.
It has been revealed by the researchers from the Albert Einstein College of Medicine of Yeshiva University in New York that the genetic process of recombination is most likely the one responsible for the heightened risks of conditions like Down syndrome.
The process where pairs of chromosomes exchange genetic material before separating is called recombination. The researchers discovered that in older mothers, recombination may be less regulated. This could lead to abnormal chromosome numbers in sex cells or large rearrangements of chromosomes. Women’s health decreases as women age in terms of increased rates for having a baby with congenital anomalies.
The risks of getting a miscarriage slowly rise with the mother’s age. A study that was published in the BMJ has found that the risk of miscarriage for women aged 20 to 24 years is around 8.9% and it grows to 74.7% for those aged 45 years and above. The diminishing caliber of women’s eggs is the one most likely responsible for the increased rates of miscarriage. Women’s health in terms of egg quality decreases as women continue to age.
Stillbirth is more probable to occur in older women than in younger women. A review published in the Canadian Medical Association Journal discovered that stillbirth is about 1.2 to 2.23 times greater in older women.
Another research investigated data from 385,120 pregnancies in the UK. It was observed that the rate of stillbirth was 4.7 per 1,000 for women who are between the ages of 18 to 34, 6.1 per 1,000 for those who are between the ages of 35 and 40, and 8.1 per 1,000 for women who are aged 40 and beyond. It has also shown that the rate is greater in people who are having their first baby and even greater if first time mothers who are age 35 or older.
Women who are at age 35 and older are mostly recommended to be induced as they are nearing their due date because of the higher risk of stillbirth with gestational age. About one out of on thousand women who are below 35 years old have stillbirth during 39 and 40 weeks of gestation. Compare this with 1.4 out of 1,000 women who are between the ages 35 to 39, and 2 out of 1,000 women who are aged 40 and over.
Women’s health diminishes as women age in terms of possible stillbirth deliveries. It is still unclear what the reasons are for the rate of stillbirth that increases with maternal age.
There has been a research that compared pregnancy complications in women who are aged between 18 to 34 years, 35 to 40 years, and 40 and above. It was revealed that small growth in most pregnancy and birth related complications with age.
The authors of the research identified increases in the risks of gestational diabetes, placenta previa, breech positioning of the baby, emergency caesarean delivery, postpartum haemorrhage, preterm birth, low birth weight, and high birth weight. The risk of maternal mortality increases with age as well according to another research. Generally, women’s health in terms of possible multiple risks involved in pregnancy decreases as women continue to age.
A research presented at last year’s American Stroke Association’s International Stroke Conference has revealed that pregnant women who are aged 40 and above have a higher risk of ischemic stroke, hemorrhagic stroke, heart attack, and death from cardiovascular disease than those who are pregnant at a much younger age.
Dr. Qureshi and his colleagues at his institute discovered that all the risks, aside from hemorrhagic stroke, were clarified by commonly known risk factors for cardiovascular disease like high blood pressure, diabetes, and high cholesterol. And these are usual conditions that older pregnant women deal with.
Clarity for Birth Complications?
Pregnant women’s health at age 35 usually has birth complications. A study published in The Journal of Physiology gives clarity on why women above 35 are more prone to deal with birth complications. The researchers from King’s College London in the UK have discovered that a mother’s age impacts the structure of the uterus.
Using a mouse model, the group of mice that represented women over 35 years old had impaired muscle contraction properties in the uterus that are less sensitive to oxytocin, and have lesser numbers of mitochondria. All of the mentioned factors suggest that the uterus muscles are less likely to contract properly. The researchers have also found changes in progesterone signalling. As a result, a delay in labor is triggered.
According to the lead investigator of the study, there are key physiological and cellular changes that are linked with a mother’s age that could yield to labor dysfunction and that maternal age is also connected with the timing of delivery and the progress of labor, which could cause childbirth complications.
Previous studies have stated that there’s a higher risk of low birth weight and preterm birth for women who are aged 35 and above. But, a recent study suggests that a mother’s age is not the reason for such conditions.
The recent study was published in the American Journal of Epidemiology and has discovered that the reasons are more connected with individual circumstances or behaviors that usually happen in older adults. Potential reasons for these factors could be fertility problems, which are related with poor birth results, maternal stress, and unhealthy behaviors.
According to the director of the institute that conducted the research, women should not be overly concerned about their age when it comes to considering in having a baby. Individual life circumstances and behavioural choices are supposed to be considered more than age.
There are pros and cons for delaying parenthood. For those who prefer to postpone parenthood, consider factors such as declining fertility and higher risks of miscarriage and birth complications. Stillbirths may be rare, but the risk is still greater for older women and it even increases during the last weeks of pregnancy.
The advantages of delaying motherhood until after age 35 are there are fewer behavioral, social, and emotional difficulties for children of older mothers. According to another study conducted by the same researchers, being born later is also linked with being healthier, taller, and getting more education.
Regardless of the risks, most women who are 35 and above are more likely to have a normal pregnancy accompanied by a few birth complications, and continue to giving birth to healthy baby.
Submitted by Dr. Richard Honaker: http://www.independentmedicalexaminer.com/IME-Directory/Virginia/Dr-Richard-A-Honaker-MD.asp
Disclaimer: This article provides general information and is not intended to diagnose, treat or cure any disease or medical condition. If you require specific advice, please consult one of our medical professionals through the app. However, in case of an emergency, please call 911.