Posted on 03/29/2017 in Infertility

Pregnancy and Childbirth Over 40

The birth rate for women aged 40-44 first started increasing in the 1980s and more than doubled from 1990 to 2012, according to the CDC. The most recent CDC data from 2015 shows:

  • Birth rates for women aged 35–39 increased steadily by 13% since 2010
  • The birth rate for women aged 40–44 in 2015 was up 4% from 2014
  • The number of births for women aged 45 and over increased 5% in 2015.

More than 60% of our practice is over the age of 35 and probably about 25% is over 40. We’ve seen a steady climb in older moms over the last five to 10 years and we even saw these numbers increase last year over the year before. That rise is evident in research studies too.

What challenges might women over 35 face when trying to get pregnant?

There is an increased risk of infertility as you get older. There’s also an increased risk of miscarriage. Between ages 35 and 44, the risk of miscarrying increases up to 40% and over the age of 44 it can be as high as 50 or 60%. You’re more likely to have chronic medical conditions as you get older too, so things like hypertension, obesity and diabetes can certainly complicate pregnancy for older moms as well.

 What is different about pregnancy for older moms?

Most complications associated with pregnancy increase significantly as you get older. That includes miscarriage, pre-term delivery, risk of cesarean delivery, risk of stillbirth, growth restriction (in which the baby doesn’t grow as much as it should), preeclampsia, hypertensive disease (high blood pressure-related conditions), diabetes in pregnancy, placenta previa (where the placenta covers the cervical opening), and placental abruption (where the placenta detaches from the uterus).

What health concerns might you have for a baby born to a woman over 40?

There is an increased risk of chromosomal abnormalities like Down syndrome. There is also a higher risk of congenital anomalies such as cardiac defects. The number of multiple gestation pregnancies (twins/triplets) also increases. Multiple gestation pregnancies are associated with an even higher risk of some of the complications already mentioned. The risk of multiples is increased by advancing age and also use of assisted reproductive techniques.

In addition to talking about risk factors, exercise and staying healthy, we stress the need for good follow up and ultrasound evaluation of the pregnancy and making sure they are with a physician that is aware of potential risks.

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