227. Safe Pregnancy after Age Thirty-Five
Age is not the biggest factor in a healthy pregnancy. The biggest factor is the good health of the mother.
Becoming pregnant after the age of 35, however, poses a number of potential problems. Chances for conception decrease with age. The incidence of miscarriage and premature birth is slightly higher in later-life pregnancies. So is the likelihood that the mother will develop diabetes or high blood pressure. The chances that a baby will be born with a genetic defect increases, too. So along with other health considerations, a pregnant woman in her mid-thirties or older should:
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•Discuss with her doctor, in detail, her pregnancy plans, risk factors, and measures she needs to take for a healthy pregnancy.
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•Talk to her doctor about prenatal genetic tests.
About Amniocentesis
Usually performed at about 16 weeks into the pregnancy, amniocentesis can detect Down’s syndrome, Tay-Sachs disease, sickle cell anemia, Rh incompatibility, and spina bifida. (Amniocentesis will also reveal the sex of the child, but it’s never done for that purpose alone.) The doctor uses a long needle to draw out a sample of amniotic fluid, which is tested for genetic abnormalities. The test itself presents some risk—there is about 1 chance in 100 to 1 chance in 200 that a miscarriage may occur.
Amniocentesis is justified under the following conditions.
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•The pregnant woman is 35 years old or older or requests genetic testing.
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•Someone in the mother’s or father’s immediate family (a parent, sibling, or child) has a genetic or metabolic disorder.
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•There is a family history of hemophilia (a bleeding disorder) or spina bifida (a neural tube defect).
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•An earlier pregnancy produced a baby with chromosome abnormalities.
Amniocentesis can’t detect abnormalities such as a club foot or cleft palate, so normal results don’t necessarily guarantee a normal baby. Another technique called chorionic villous sampling (CVS) analyzes a small sample of the placenta and can be performed earlier than amniocentesis, (between weeks 8 and 12 of the pregnancy). The earlier testing is done, the more time the prospective parents and their doctor have to decide on the best course of action.
