More women over 35 years are having babies than ever before. Most women over 35 years have normal pregnancies; however, others may need special care before and during pregnancy.
When you are aged 35 years or older there are some particular things you need to think about before becoming pregnant. Once a woman reaches 35 years she has a greater chance of:
- fertility problems
- having a miscarriage or foetal loss in the second or third trimesters
- developing diabetes or high blood pressure while pregnant
- being constantly tired when pregnant
- giving birth by caesarean section (surgery needed to deliver a baby)
- having babies with chromosomal problems such as Down's syndrome
- having multiple births.
By working with your lead maternity carer and getting regular prenatal care, you will help ensure a healthy and rewarding pregnancy.
As women and men age, getting pregnant can become difficult. In general, if you are over 35 yrs old and not pregnant within 6 months of trying (no contraception, regular sexual intercourse at your fertile time of the month, regular periods and cycle) then see your doctor and see if referral to infertility services is advised.
There are two screening options available for you if you choose to have antenatal screening for Down syndrome and other conditions. This is particularly recommended for women age 35 and older as the risk for conditions such as Down Syndrome increases with increasing age of the mother.
The two options now available include first trimester combined screening and second trimester maternal serum screening. The screening tests are able to pick up most cases, where there is an increased chance that you are carrying a baby with Down syndrome, Turner syndrome, Trisomy 13 and Trisomy 18. Occasionally it can pick up that you are potentially at risk of a pregnancy related health condition.
First trimester combined screening This screening is available if you are less than 14 weeks pregnant and includes a blood test and an ultrasound scan. Results from both the blood test and the scan are combined with other information like your age, weight and baby's gestational age (how many weeks pregnant you are) to come up with a relative risk score.
Second trimester maternal serum screening
This is a blood test, best taken between 14 - 18 weeks but can be taken up until 20 weeks. This test looks for the levels of four analytes (chemicals) in your blood. From these levels, a risk score of low or increased is calculated after also taking into account your age, and related factors. The chemicals tested include:
- β-HCG (Beta Human Chorionic Gonadotrophin)
- µE3(Unconjugated oestriol)
- AFP (Alpha fetoprotein)
- Inhibin A
Genetic counselling studies the risk of birth defects for your baby. As you get older, the risk of having a baby with a chromosomal abnormality gradually increases. You should ask your lead maternity carer for details. You will be asked detailed questions about your family health history. The information gained can help you and your lead maternity carer learn whether the fetus has a risk of health problems.
Diagnostic testing - CVS and amniocentesis
- If screening shows that there is an increased risk for a genetic condition (like Down syndrome, Trisomy 13, Trisomy 18 or Turners syndrome), amniocentesis or chorionic villus sampling (CVS) are the usual options for diagnostic testing.
- Amniocentesis is a test that studies amniotic fluid (liquid that surrounds the fetus in the womb). It can help diagnose birth defects and other medical problems and was commonly offered to women aged 35 years and older before the maternal screening tests were available.
Pregnant! What do I need to know Health Navigator NZ
Boosting your fertility Fertility Associates (NZ)
First and second trimester combined screening test National Screening Unit (NZ), 2014\
Pre-conception care in general practice Best Practice Journal (BPJ) and Best Practice Advisory Centre (bpacNZ), 2011
Routine laboratory testing during pregnancy Best Practice Journal (BPJ) and Best Practice Advisory Centre (bpacNZ), 2011