Over 40: Will Age Impact Your Pregnancy?

I am 42 years old and eight weeks pregnant with my fifth child. Although I am thrilled to be pregnant, I am concerned about my age. Should my pregnancy be managed differently?

Question:

You should be thrilled to be pregnant. It is wonderful to see mature women having babies; the social science statistics suggest that you raise children more likely to do well in school and be professionals. Not that you can't do a good job when you are younger, but the likelihood of "successful" child rearing gets higher with age.

Having said that, there are still some risks that increase with age related to pregnancy. The most obvious is the increase in risk of chromosome problems like Down syndrome. At your age, the risk of a chromosome problem is 1 in 42. With a normal level two ultrasound, the risk is reduced by half, to about 1 in 80. This is still a low risk (79 in 80 chances that the baby won't have a chromosome problem) but substantially increased from when you were younger. As such, we offer extra testing to see if the baby has a chromosome problem -- an amniocentesis. This carries a risk (1 in 200) of losing the baby, though, so you have to weigh the risks and benefits carefully before deciding.

Other risks depend on your health. Some studies have indicated an increased risk for growth problems, preterm labor, preeclampsia, high blood pressure, & diabetes. It is hard to factor out the effects of age alone from the increased chances of those diseases becoming evident as we go through life, which would then make the pregnancy higher risk just on the basis of the disease you have. So, if you are in good health, the risks appear to be minimally elevated over normal. We still would watch a little more closely for problems, but essentially you would have normal care unless something showed up on your routine visits.

For now, just be excited about the pregnancy. You will find that you may be more tired than when you were 20, that you have more aches and pains, and there will be days you wonder why you did this. But overall, you will be the mature stable mother every child needs.

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