All pregnancies carry risks. There is, however, no getting around the statistical fact that risks increase with pregnancy over 40. While the doctors are quick to point out the risks (as they should), it is also important to remember that more women over the age of 40 are giving birth to healthy babies today than ever before.
I moved forward with trying to conceive at the age of 44 with a strong knowledge of the risks and mitigations. I also had impeccable prenatal care with doctors who were supportive yet realistic. Below are some of the major risks that you should be aware of:
- Miscarriage. According to the March of Dimes, the risk of miscarriage is about 10% for women in their 20’s; 20% for women in their 30’s; 35% for women 40-44 and 50% for women over 45. In my experience with pregnancy over 40, I had two pregnancies and one ended in miscarriage.
- Preeclampsia. Preeclampsia is essentially high blood pressure during pregnancy. This can be dangerous and or fatal for the mother and baby. Risk of preeclampsia increases over the age of 40, can come on suddenly; and often has unknown causes.
- Genetic disorders. Today, most women over the age of 35 will undergo screening for likelihood of genetic disorders before any invasive diagnostic tests are performed (CVS or amniocentesis). The AFP (Alpha-Fetal Protein) or Quad Test takes place at 16 to 18 weeks of pregnancy. It is designed as a screening (not diagnostic) tool to estimate risk for Down syndrome (trisomy 21) and certain chromosomal abnormalities, such as neural tube defects, spina bifida, and trisomy 18. If the risk rating for this test is in the “acceptable” range, most women will not move forward to undergo amnio or CVS which each are considered invasive and carry a risk of miscarriage. Another screening tool which many times is not covered by insurance is nuchal translucency (NT). This test is conducted during an ultrasound and measures the fold of skin at the back of the baby’s neck. If the fold is within a certain range, the risk of Down’s syndrome is higher and CVS or amnio may be requested to diagnose or rule out Downs. When I had my genetic screening, the nurse warned me that the ratio would come back with a high risk of genetic abnormality due to my age. I asked why the screening didn’t just depend on the pure science of the test results. She told me that age is a large factor in abnormalities and is figured in heavily with this screening tool. She told me not to worry because almost every woman over 40 has a screening with high risk ratios. I was thrilled and surprised when my results came back in the “normal” rather than “elevated ” risk range. I was given the option of moving ahead with CVS or amnio but did not based on the normal results from both the triple test and the NT test. I delivered a healthy baby girl at full term.
Medical science provides many tools today for women trying to get pregnant over 40 to gather information about the health of their unborn child. Some women opt out of these tests because the results would not change their thinking about the child inside of them. Whatever your philosophy, you have the options for gathering lots of information to help in making informed decisions about your pregnancy over 40, your health and your child.