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Pregnancy After 35: What’s the Big Deal?

You’ve probably heard that getting pregnant after 35 carries more risks, and you may have even heard the terms “geriatric pregnancy” or “advanced maternal age.” So most people have heard that there can be concerns about pregnancy after age 35, but they don’t always talk about what that actually means. In this post, we’ll discuss what the research shows about pregnancy and birth after age 35 and how to prepare if you’re planning a pregnancy for your mid or late 30s.

The likelihood of possible complications in pregnancy—including miscarriage, placenta issues like placenta previa, preeclampsia, and gestational diabetes—and with baby, such as Down syndrome and stillbirth, is a little bit higher for pregnant people older than 35 and even higher for those older than 40. If you’re pregnant and older than 35, try not to worry, as these increased risks are very low and the risk of these things happening no matter how old you are is very low. Plus, experts agree that there’s not anything that happens on your thirty fifth birthday that makes pregnancy more risky; it’s more of a very gradual increase in the risk for these complications.

And the medical community has responded to these risks by increasing care for pregnant people in their mid-thirties. In a study published in December in JAMA Health Forum, Caroline Geiger, a health economist at biotech company Genentech, and colleagues looked at prenatal care and outcomes in more than 51,000 pregnancies. [1] About half of the study participants were between 35 and 35 and four months at their due dates and received an advanced maternal age diagnosis. The other half were between 34 and eight months and 34 and 11 months at their due date—just shy of the point at which they would be considered to be of advanced maternal age.

The researchers found that pregnant people who would be classed as advanced maternal age received more care in the form of prenatal ultrasounds and visits with care providers, as well as more checking in after birth. This group also had a small decrease in stillbirth and early neonatal death. The authors wrote that the increase in prenatal care received by pregnant people in the advanced maternal age category could contribute to the observed decrease in perinatal mortality. At the same time, this finding is an association, but doesn’t imply causation, and the authors acknowledge that it’s not clear from this work which parts of the increased prenatal and postpartum care may be linked to improved outcomes.

In a story about the research published in USA Today, Priya Rajan, a maternal fetal medicine physician and chief of diagnostic ultrasound at Northwestern Medicine who was not involved in the work, explains that there are several factors, such as timing of delivery (whether the pregnancy was pre or full term) and the number of previous pregnancies, that might also contribute to the decrease in perinatal mortality that the authors observed. [2] Rajan also pointed out that, in the study, the increase in prenatal care for people who were designated as advanced maternal age did not appear to change maternal mortality.

So what does this mean for you if you are in the midst or on the cusp of a geriatric pregnancy? First, make sure that you have a care provider whom you trust. The most important thing for any pregnancy is to feel that your care provider—doctor or midwife—listens to you and honors your concerns. Second, trust your intuition. You can ask questions and request more care if you feel worried about your or your baby’s health. Third, do your best to take care of yourself during your pregnancy. Babies generally get what they need—nutrition, fluids, vitamins—from their mom, but it’s hard to make sure that you’re also cared for too. No matter what age you are, eat a variety of foods that sound good to you, move your body (swimming, yoga, and hiking are all great options), and pay attention to the things that energize you.

References

  1. K. Geiger et al., “Association of Prenatal Care Services, Maternal Morbidity, and Perinatal Mortality With the Advanced Maternal Age Cutoff of 35 Years, ”JAMA Health Forum, 2021.
  2. Rodriguez, “Pregnancy risks increase with age but there’s no reason to believe risks ‘jump’ after turning 35, study suggests,” USA Today, 2021.
Abby Olena
Dr. Abby Olena has a PhD in Biological Sciences from Vanderbilt University. She lives with her husband and children in North Carolina, where she writes about science and parenting, produces a conversational podcast, and teaches prenatal yoga.

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