Minimizing the risks of pregnancy when mom's older than 35

Because of the risks associated with pregnancy after 35, Tracy Sharp, third from left, nurse manager of the Family Birthing Center at St. Catherine Hospital in East Chicago, waited until the end of the second trimester to announce she was expecting her second child.

When Tracy Sharp was 32 and pregnant for the first time, she was excited and eager to tell the world as soon as she learned the news. Eight years later, her thoughts about being pregnant turned to concern.

“I was very worried about the risks associated with having a baby after age 35,” says Sharp, nurse manager of the Family Birthing Center at St. Catherine Hospital in East Chicago, who began working in labor and delivery while pursuing a nursing degree from Indiana University.

Her concerns centered on the knowledge that women older than 35 were at higher risk for miscarriages, gestational diabetes and pre-eclampsia, and their babies were at higher risk for chromosomal disorders such as Down syndrome. “I told people only at the end of my second trimester," she said.

Sharp also experienced differences in the way her body reacted to her pregnancy. She found that her energy level was much lower and that she tired more easily at 40 than 32. From a supermom who never needed assistance to a woman who accepted all the help offered and slept as often as she could, the two pregnancies were radically different.

Dr. Anthony N. Gentile, chairman of OB-GYN department at Community Hospital in Munster, was at Yale University when a study looked at Caesarean sections and maternal age.

“This study, published in 1993, confirmed that maternal age was an independent risk factor for C-section,” he says. “The reasons for this are not fully understood, but we know that there are other associated complications that occur with increasing age with women, including increases in high blood pressure and eclampsia, increases in diabetes and increases in weight that all contribute to more complicated pregnancies and higher C-sections.”

“One of the risks during pregnancy when we’re older are chromosomal defects,” says Dr. Jeannette Colon-Marin, a member of the American Board of Obstetrics & Gynecology who practices in Valparaiso. “The older you are the greater the risk of having a baby with a birth defect. The most famous of this is Down syndrome or trisomy 21. You can be genetically tested now by the 10th week of pregnancy to see if you are carrying a fetus with some of these chromosomal defects."

Developing high blood pressure, pre-eclampsia and heart conditions can be prevented by being healthy before conceiving, Gentile says. "Another risk factor is diabetes, which increases with age. A good safeguard for this is maintaining a normal healthy weight and eating properly prior to conceiving.”

Weight gain is necessary, but it should be within limits that depend on the mother's weight before pregnancy with the average weight gain between 10 to 35 pounds over the nine-month course of the pregnancy.

“Women with average weight before pregnancy should gain 25 to 30 pounds,” Gentile says. “Underweight women should gain between 28 and 40 pounds. Overweight women should gain between 15 and 25 pounds. On average, half of the weight gain occurs by the 28th week of pregnancy and the other half occurs between the 28th and 40th week.”

Symptoms signaling high blood pressure — headaches, vision changes, swelling of the face/hands/feet, shortness of breath, chest pain, vaginal bleeding, reduced fetal movement — and signs of diabetes — frequent urination, excess thirst and excessive hunger pangs — need to be discussed with a woman’s obstetrician.

“None of this means a woman older than 35 can’t have a perfectly healthy baby,” Colon-Marin says. “They do, it’s just the risks increase with age.”