Risks, Benefits, What to Expect

Pregnancy can be an exciting but challenging time in a person’s life. It is possible to become pregnant at age 35 or older, but this may carry some risk. This is known as a pregnancy of advanced maternal age (formerly referred to as a geriatric pregnancy).

This article will discuss advanced maternal age pregnancy, risks associated with pregnancy at this age, and how to have a healthy pregnancy at 35 or older.

What Is a Geriatric Pregnancy?

“Geriatric pregnancy” is a term once used to describe a pregnancy for a person over 35.

However, a more appropriate term is “pregnancy of advanced maternal age.” There is no universal definition for advanced maternal age, but typically it is considered a pregnancy over age 35.

In recent decades, there has been a rise in births to those of advanced maternal age. This may be due to people delaying childbearing for careers or financial security.

Reproductive technologies have also resulted in a larger window in which females can reproduce, which is also associated with an increase in the number of pregnant people of advanced maternal age.

Risks of Pregnancy After Age 35

A pregnancy in a person of advanced maternal age carries various risks for both the pregnant person and baby. Those of advanced age when pregnant are at greater risk of complications.

Miscarriage

A miscarriage is when a fetus dies before 20 weeks. While there are many potential causes of miscarriage, pregnant people of advanced maternal age are at an increased risk of miscarriage compared with their younger peers.

A 2019 study of more than 421,000 pregnancies found that the rate of miscarriage was lowest among those between ages 25 and 29 but rose significantly at 30. By 45, the risk was more than 53%.

Conditions Present at Birth

Health and genetic conditions and physical variations may be present when the baby is born. Some of these occur more often when the pregnant person is over age 35. These conditions can cause issues with a baby’s overall health and development.

As a female gets older, the odds increase of having a baby with an extra chromosome or a chromosome that is missing or damaged. Down syndrome is one of the most common chromosomal disorders associated with advanced maternal age.

The risk of having a pregnancy with Down syndrome by age is:

• 1 in 1,480 at age 20
• 1 in 940 at age 30
• 1 in 353 at age 35
• 1 in 85 at age 40
• 1 in 35 at age 45

Preeclampsia

Preeclampsia is a serious condition that can affect multiple organs in the body. It is characterized by high blood pressure and elevated protein levels in the urine. Liver and kidney damage may occur.

Preeclampsia typically occurs after 20 weeks of pregnancy, in the third trimester. But it can also develop in the weeks following childbirth. Pregnant people of advanced maternal age are at moderate risk for preeclampsia.

Delivery Complications

Advanced maternal age is associated with a range of potential delivery complications, including:

Additional Risks

Advanced maternal age may also be associated with other risks, including:

• Taking longer to become pregnant: A person with ovaries is born with all the eggs they will ever have, and by their mid-30s, they have fewer eggs. As eggs age, their quality deteriorates, making fertilization more difficult.
• Gestational diabetes: The older the age, the greater the risk of gestational diabetes, in which blood sugar is high.
• Multiple pregnancy (twins, triplets, or more): Females of older age are more likely to become pregnant with twins or triplets. This can lead to complications during pregnancy.

Benefits of Pregnancy After Age 35

While advanced maternal age is associated with risk, there are also benefits to pregnancy at a later age.

These include:

• Socioeconomic stability
• Better health behaviors in pregnancy
• Among those in developed nations, better health and educational outcomes for children

Having a Healthy Pregnancy After Age 35

There are many steps people can take to have a healthy advanced maternal age pregnancy. These include:

• Getting a checkup before becoming pregnant
• Getting all needed vaccines before and during pregnancy
• Treating any conditions like high blood pressure before pregnancy
• Taking folic acid before becoming pregnant and during pregnancy
• Maintaining a healthy weight
• Avoiding alcohol, tobacco, and drugs both before becoming pregnant and while pregnant
• Reducing stress
• Having regular healthcare provider appointments throughout pregnancy
• Continuing with any treatments a healthcare provider advises during pregnancy
• Eating a healthy diet in pregnancy
• Remaining physically active in pregnancy

Summary

“Geriatric pregnancy” is an outdated term that refers to a pregnancy for a person 35 or older. A more appropriate term is “pregnancy of advanced maternal age.”

A pregnancy in a person 35 years old or older carries some risks for both the pregnant person and fetus. This includes pregnancy and birth complications, as well as the possibility of conditions present at birth.

Maintaining a healthy lifestyle and consulting regularly with a healthcare provider can help ensure a healthy pregnancy at 35 or older.

A Word From Verywell

Pregnancy can be exciting but daunting. If you are considering a pregnancy and are 35 or older, reach out to a healthcare provider for advice. They will be able to help you during this exciting journey.