As millions of American women can attest, giving birth later in life -- even in the mid-40’s -- is becoming a common occurrence.

“Overall, many women are discovering that having babies later in life can be a wonderful gift,” said Dr. Adina Keller, Obstetrician and Gynecologist at MKMG’s Mount Kisco office. “Though relatively uncommon, there are some increased risks for pregnant women over the age of 35 that they should know about.”

Risk of Miscarriage

Women 35 and older generally have a higher incidence of miscarriage in the first trimester than younger women do. While the percentage of miscarriages in older women is still very low, Dr. Keller points out that women should be aware of the possibility.

“Miscarriages are very difficult to deal with,” she said. “However, if they are willing to try again, most women can overcome the experience and go on to deliver healthy babies.”

Genetic Risks

Women over age 35 run an increased risk of delivering babies with chromosomal abnormalities, such as Down’s Syndrome. Two procedures can detect these conditions early in the pregnancy. Amniocentesis is most widely used, while Chorionic Villus Sampling (CVS) is used more sparingly.

During amniocentesis, a fine needle is used to extract amniotic fluid for testing. Since the genetic makeup of a child can be found in the the cells which are shed into the fluid that surrounds it, this test provides conclusive evidence of any abnormalities. Amniocentesis is typically performed 15-20 weeks into pregnancy, under the guidance of ultrasound. It is performed by an obstetrician with or without a radiologist present, and it takes approximately 5-10 minutes. Patients may feel minimal discomfort during the procedure, and should rest for the next 24 hours.

CVS can be performed earlier than amniocentesis (10-12 week of pregnancy), either by an obstetrician, such as MKMG’s Dr. Kevin Reilly, or a perinatologist. CVS uses a fine needle to extract a sample of placental tissue for genetic testing.

“Both amniocentesis and CVS pose certain risks to the fetus,” Dr. Keller explained. “However, for older women, the risk of having an abnormal pregnancy outweighs the risk of the procedure itself.”

Because CVS is slightly riskier than amniocenteses, this option is usually reserved for women with a known family history of abnormalities, or those who have already had a child with a similar diagnosis.

Counseling

All pregnant MKMG patients visit with a genetic counselor prior to having amniocentesis or CVS. During the consultation, women and their partners are interviewed about their history and educated about risks and consequences. The couple can also ask in-depth questions of an expert in the field.

“Genetic counseling is a great way to prepare for testing,” Dr. Keller said. “And, it prompts couples to think seriously about what they will do with the information when they receive it.”

Risk of Disease

]While still uncommon, preeclampsia (elevation of blood pressure) and gestational diabetes occur more frequently in older women. During every office visit, patients are screened for signs of preeclampsia, which include swelling of the feet, hands and face, and protein in the urine. Preeclampsia typically occurs during the third trimester, and can be dangerous to both the mother and child. While there are several ways to manage it, the ultimate cure is to deliver the baby.

Screening for gestational diabetes is performed 28 weeks into the pregnancy via a 1-hour glucose challenge test. Patients are given a drink called GlucolaTM, and then have their blood tested for abnormal glucose levels. If abnormal levels are detected, patients undergo additional testing to determine whether or not they have gestational diabetes. Gestational diabetes increases the likelihood of developing diabetes later in life. The baby may also grow too large within the uterus, increasing the risk of problems during the pregnancy.

Women with gestational diabetes meet with a dietitian, who counsels them on maintaining a diabetic diet and monitoring their own blood sugar levels. Other treatments may also be given, depending on the severity of the condition.

“While the risks to pregnant women do increase with age, the odds are still small that complications will occur,” said Dr. Keller. “For the opportunity to deliver and raise a child of their own, most women find they are more than willing to take the chance.”

For more information about pregnancy and childbirth, contact your MKMG Obstetrician.