Advanced Maternal Age Pregnancy (Geriatric Pregnancy)
The answers given by the majority of those who want to be mothers at an advanced age (other than those with health problems); It is either “I don’t feel ready right now” or “I have a little more time to offer him a good future financially” or “My priority is my job”. It can be overlooked that this idea, which increases in direct proportion to time, actually comes with many problems when it is said that “now is the time”. It is necessary to go to the doctor 2-3 months before and get pregnant after all the checks are done.
The term “advanced maternal age pregnancy” is used for pregnancies after 35 years of age. Such a definition was made as the negative changes in egg quality and maternal health as age progresses adversely affect the course of pregnancy. Of course, not everything changes suddenly after the age of 35, but the risks increase as you get older.
Egg quality deteriorates with age
The defect in egg quality affects the genetic condition of the baby. Women are born with a certain number of eggs. As the age progresses, while these eggs decrease, their quality deteriorates, so the rate of eggs with a genetic structure increases compared to normal ones. While this situation reduces the possibility of getting pregnant, it causes miscarriage and especially the possibility of Down syndrome to increase. Screening tests such as double and triple test, chorionic villus biopsy, amniocentesis enable these babies to be identified beforehand.
Pregnancies after age 40 may result in more miscarriages
While the probability of getting pregnant every month under the age of 30 is more than 25%, this rate decreases with age. It is around 5% after the age of forty. Pregnancies under the age of 30 have a 10% chance of resulting in miscarriage, and after the age of 40, nearly half of the pregnancies end in miscarriage. Again, at the age of 35, the probability of Down syndrome increases from one in 350 to one in 70 at the age of 40. This condition, which is related to the egg factor, is directly related to age and has nothing to do with the general health status of the woman.
There may also be ectopic pregnancies
Pelvic inflammations and endometriosis are diseases that damage the ducts. These problems affect more women with advancing age. As a result, we encounter more ectopic pregnancies as well as difficulties in conceiving.
Career plans are also one of the reasons for late pregnancy
Despite all these negativities, we see more pregnancies of advanced maternal age pregnancy in the modern world. This rate is increasing because women are getting married later. Career plans and difficult living conditions cause them to delay having children. As the success of infertility and IVF treatments increases, the experiences in advanced maternal age pregnancies increase. Especially with egg donation, we come across pregnancies after 45 or even 60 years of age.
Risks are not directly proportional to age
Based on these experiences, we can say that advanced maternal age pregnancy does not affect the course of pregnancy as dramatically as genetic deterioration in the egg. A woman in good general health can have a healthy pregnancy after the age of 40. Risks are related to the presence and duration of other diseases rather than age.
Factors such as blood pressure, diabetes, heart disease, and excess weight are more common in older mothers. The older the woman is, the older these diseases are and the more damage they cause to the body. As a result, the negative effects on pregnancy and baby are more.
The most common chronic diseases with advancing age are diabetes and high blood pressure.
Blood sugar should be checked
Type 2 diabetes is a disease that occurs with age. Before getting pregnant, blood sugar needs to be checked and regulated if it is high. High sugar in the first three months of organ production in the baby causes low blood sugar and worse, organ anomalies.
Pregnancy-related sugar elevation is also more common in advanced maternal age pregnancy. While sugar is normal at first, sugar cannot be burned with the effect of pregnancy hormones. This situation is 24-28. It is determined by the loading test performed in weeks. It usually improves with diet, if necessary, insulin is used.
Uncontrolled sugar causes enlargement of the baby, increase in water, premature birth and sometimes the loss of babies.
Pay attention to blood pressure
During pregnancy, blood vessels expand and blood pressure drops slightly. The purpose of this is to provide more blood flow to the baby. High blood pressure prevents the baby from feeding. Its development slows down, its water decreases. It causes premature separation of the spouse of the baby, premature birth or loss of the baby. Pregnancy poisoning is also more common in those with high blood pressure. This picture, in which edema, protein in the urine and high blood pressure are seen, is a serious condition that threatens the mother’s life in its later stages.
Complications due to chronic diseases increase the frequency of hospitalization before delivery, and the observation period may be longer after delivery. The duration of normal labor in advanced maternal age pregnancy is also slightly increased compared to young people. The frequency of application to cesarean section is 2-3 times higher.
All these require that women who plan to have children in later ages should act more planned. 2-3 months before conception, a short health screening should be done by going to the doctor, especially excess weight should be lost.