Pregnancy after 30 years of age

Is Any Age Good For Getting Pregnant? What is a "geriatric" pregnancy and up to what age can you get pregnant? How many women give birth to the first child in their 30s? Is pregnancy different in a woman over 35? What is the risk of having a baby at this age and what tests are recommended at that time? Are there any special symptoms in late-age pregnancy? Read on to find out what it means in practice to become a mother not only in your 30s, but also in your 35s.

Regardless of technological advances, cultural and social changes, the peak of female fertility falls at the beginning of the third decade - between the ages of 20 and 25. As the years go by, the possibility of getting pregnant decreases. In the age of 30-35 by about 15-20%, and in the next decade (up to the age of 45) by 50-95%. Dry statistics, however, can hardly be considered as an answer to the frequently asked question, up to what age can you get pregnant. The question of fertility is one thing, but when deciding on late motherhood - whether it will be your first or the next child - it is good to know the risks of pregnancy after the age of 35 and what to do to minimize them.

Until what age can you get pregnant?

Theoretically, it is possible to conceive spontaneously as long as the menstrual cycle continues. In Poland, most women will be around 50-55 years of age. And this is the answer to the question of what age you can get pregnant. Of course, due to the decrease in the number of ovulation cycles, spontaneous conception after the age of 50 is a rare occurrence, but it does happen. Sometimes, in literature or on the Internet, you can come across the phrase "geriatric pregnancy".

Increasingly late motherhood: the first child over 30 

Currently, for various reasons (socioeconomic or personal), women decide to have their first child in their 30s. Based on data from the Eurostat survey for 2017, the average age of a mother giving birth in Poland is 29.5 years. Unfortunately, we do not have information here about the division into women giving birth for the first time and the next time. A statistical Pole is not yet giving birth to the first child after 30, but the average age in other European Union countries is 30.7 years. At the latest, it is Spanish, Italian, Greek and Portuguese women who decide to become a mother.

It is worth noting that in 2008 the average age of a Polish woman becoming a mother was 28.5 years.

How to prepare for pregnancy after the age of 35?

Preparing a woman for pregnancy after the age of 35 is not very different from the preparation of mothers who give birth earlier.

It is recommended that:

• prophylactic use of folic acid;
• performing tests for chronic hepatitis B and C, HIV;
• it is also worth measuring fasting glucose and lipid profile;
• take care of the possible supplementation of vaccinations (rubella, smallpox, hepatitis B);
• if the expectant mother suffers from a chronic disease, it is important that the medications used so far are assessed for safety in pregnancy and possibly changed to those that will not affect the developing embryo and fetus;
• the obvious fact is the resignation from stimulants, which can also reduce the chances of conceiving.

Late pregnancy: symptoms

In relation to late pregnancy rather hard to pinpoint symptoms different from those experienced by women expecting a baby at a younger age. If the pregnancy is not planned, it may happen that even fairly obvious symptoms are overlooked because the expectant mother will simply not associate them with a different condition at first.

The severity of some symptoms and ailments can be influenced by chronic diseases and other health problems, the likelihood of which increases with age.

Pregnancy at the age of 35 and beyond: risk of genetic defects

Getting pregnant after the age of 35 does not have to be, but it can be a problem. The course of pregnancy may also be associated with a higher risk of complications. The older the pregnant woman, the greater the risk - ranging from a higher risk of miscarriage in women, genetic defects in the fetus, and ending with maternal complications.

When it comes to the risk of genetic "errors" and related defects in the fetus, the differences are clearly visible when we compare the statistical data on 20- and 40-year-olds in the 12th week of pregnancy.

Risk of trisomy:

21.pairs of chromosomes (Down syndrome):

• in a 20-year-old woman - 1/1068;
• in a 40-year-old woman - 1/68.

18 pairs of chromosomes (Edwards syndrome):

• in a 20-year-old woman - 1/2484;
• in a 40-year-old woman - 1/157.

13th pairs of chromosomes (Patau's syndrome):

• in a 20-year-old woman - 1/7826;
• in a 40-year-old woman - 1/495.

Late pregnancy: ultrasound examinations

In order to detect abnormalities in the structure of the fetus and the risk of genetic defects listed above, the so-called combined test, i.e. fetal ultrasound and testing of the level of free beta hCG and PAPP-A protein in mum's blood.

In women who are pregnant after the age of 35, the examination is reimbursed by the National Health Fund in Poland, i.e. free of charge. It allows you to assess the early anatomy of the baby and the presence of markers of genetic defects. The result also determines risk of developing pre-eclampsia (hypertension in pregnancy) and intrauterine growth restriction. If the examination shows that it is high, a prophylactic dose of acetylsalicylic acid should be introduced in order to reduce the risk of these complications.

Another ultrasound, recommended for all mothers-to-be, is the 20-22 examination. week of pregnancy, accurately assessing the anatomy - the structure of the fetus and its growth. It is also reimbursed by the National Health Fund in the case of pregnancy after the age of 35. Ultrasound examination, recommended in 30-32. week of pregnancy, has not been - unfortunately - included in the reimbursed group of studies in future mothers of more advanced age.

When and what kind of invasive diagnostics in late pregnancy?

If the risk of genetic defects is estimated as high - more than 1: 300 - is recommended invasive diagnostics (reimbursed by the National Health Fund). Depending on the method chosen, it can be:

• trophoblast biopsy ("Puncture" of the future placenta) - performed at the earliest;
• amniocentesis (amniotic fluid collection) - recommended after the 15th week of pregnancy;
• cordocentesis (blood collection from umbilical vein) - after 17-20. week of pregnancy.

The risk of complications and loss of pregnancy after the examination depends on the method. It is the highest with cordocentesis (up to 2,4%), and lower with the remaining ones (0,5-1%).

It is a non-invasive examination which does not constitute a diagnosis evaluation of free fetal DNA from blood taken from a mother-to-be. They can be performed after the 10th week of pregnancy - the result is available even after 4-5 days and may reduce the anxiety of the expectant woman, but the test is not reimbursed by the National Health Fund.

Pregnancy after the age of 35: possible complications

Based on the analyzes comparing the course of pregnancy in women over 35 and younger, it was found that in the group of older mothers there is an increased risk of gestational diabetes, hypertension, premature delivery, intrauterine fetal death and surgical termination of labor. With spontaneous pregnancy, the risk - or the chance - of multiple pregnancy increases. Unfortunately, regardless of a woman's age, it carries a greater risk of maternal and fetal complications.

Childbirth at late pregnancy

Due to the more frequent complications of pregnancy in advanced mothers we rarely carry out pregnancy beyond the due date of delivery. The most frequently proposed procedure is the induction of labor for specific indications (diabetes, hypertension, inhibition of fetal growth). Also, women with no complications in the course of pregnancy and reaching the age of 40 should be invited to induce labor after the 39th week of pregnancy. It is considered biologically mature then. The aim is reduction of the risk of intrauterine death of the fetus, the cause of which, apart from the observed advanced age of the pregnant woman, has not been established. 

For various reasons, maternity plans are very different and they should not be resigned hastily, but at a more advanced age one should be aware of possible complications and, together with the attending physician, predict them, and if necessary - treat them.