Geriatric Pregnancy or Pregnancy in Women of Advanced Maternal Age

What is Geriatric Pregnancy or Pregnancy in Women of Advanced Maternal Age?

Several women nowadays are choosing to have children after the age of 35 years. Education, financial independence, relationship stability are some of the causes for this trend.

Geriatric pregnancy is a term that was used in the 1970s to refer to pregnancy observed in women over the age of 35 years. However, doctors have stopped using the term since it is not respectful to women. The current trend in Western countries e.g., Sweden, Finland, and the United States, indicates a rise in the percentage, number and rate of women over the age of 35 who give birth for the first time. Pregnant women over the age of 35 are now referred to as women of advanced maternal age (AMA).

What are the Causes of Pregnancy in Women of Advanced Maternal Age?

The choice for a woman to bear a child is influenced by personal, professional, social, and other situations in life. Today, many women are choosing to have children at a later age for various reasons. Some of them are enumerated below:

• Education
• Financial stability
• Career goals
• Relationship stability
• Confidence in partner’s suitability as a parent

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What are the Risks and Complications of Pregnancy in Women of Advanced Maternal Age?

There are risks involved in bearing children after the age of 35. Women of AMA are associated with health complications and pregnancy risks. The risks affect both the child and the mother.

Some of the complications associated with women of AMA are:

• Increased risk of cesarean section or extended labor
• Type II diabetes
• Gestational diabetes
• Leiomyomas (fibroids)
• Placenta abruption (Placenta separates from the inner wall of the uterus before labor)
• Hypertension
• Placenta praevia (Cervix is blocked by the low lying placenta)

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• Multiple pregnancies - This risk is increased with age and with the use of fertility treatment procedures. The chances of twins, triplets are increased.
• Difficulty in conceiving
• Low birth-weight babies
• Premature birth (preterm birth)
• Miscarriages and stillbirths
• Chromosomal abnormalities
• Increased chances of preeclampsia

There is no clear evidence that advanced age in mothers, leads to congenital heart defects in babies.

Some risks associated with fetuses or babies born to women with AMA are:

• Macrosomia - the head of the fetus is enlarged due to diabetes
• Birth defects in children - 1 in 65 babies of women over 40 years and 1 in 200 babies of women over 35 years

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How can Women of Advanced Age Ensure a Safe and Healthy Pregnancy?

Women at any age should take precautions to ensure a healthy pregnancy and healthy baby. This becomes all the more important in women over the age of 35 years. Prior to getting pregnant and during pregnancy, women should take adequate measures as listed below:

• Follow a healthy diet
• Try to attain a healthy weight before pregnancy after consultation with doctors
• Regular exercise
• Adequate sleep
• A daily dose of 0.4 mg folic acid one month before and during pregnancy to prevent neural tube defects in the baby

• Regular antenatal check-ups, ultrasound screening to monitor fetal well-being
• Monitoring of blood pressure, blood glucose levels and urine examination for protein and glucose regularly throughout pregnancy
• Childbirth education and counseling as appropriate
• Avoid alcohol, smoking, other harmful substances, and drugs
• Consult your family physician before trying to become pregnant

Once a woman of AMA becomes pregnant, she should make regular visits to her physician to monitor her health and that of the fetus. This will ensure timely intervention in the event of any complication.