Topic Overview

Most women who are older than 35 have healthy pregnancies. But as you age beyond your mid-30s, some risks do increase. If you are an older mother-to-be, you can increase your chances of having a healthy pregnancy. See your doctor for a checkup before you become pregnant. Keep a regular schedule of prenatal checkups when you are pregnant. Eating well and getting exercise and plenty of rest also will help you have a healthy pregnancy.

Pregnancy risks vary from woman to woman. Some pregnancy problems, such as pre-eclampsia and gestational diabetes, are more common in older pregnant women. The greatest age-related risks over age 35 are of infertility and miscarriage.

Your doctor will follow you closely to catch most problems early. At every visit, your blood pressure will be checked to make sure it is normal. Your urine also will be checked for protein. Both high blood pressure and protein in urine are signs of pre-eclampsia. You also will be tested for diabetes. You can have tests to find out whether your fetus (baby) has certain genetic problems.

Most cases of Down syndrome pregnancies (and other chromosome problems) occur in older women. If birth defects testing is done in the early part of the second trimester, fetuses with birth defects are found in about:^{footnote 1}

• 1 out of 132 women age 35.
• 1 out of 83 women age 37.
• 1 out of 40 women age 40.
• 1 out of 12 women age 45.

Because the chances that your fetus will have a chromosome-related problem increase in your later 30s and 40s, your doctor or midwife will probably recommend a birth defects screening.

Birth defects screening and testing

Pregnant women and their partners can choose whether to have tests for birth defects. It can be a hard and emotional choice. You need to think about what the results of a test would mean to you and how they might affect your choices about your pregnancy. You and your doctor can choose from several tests. What you choose depends on your wishes, where you are in your pregnancy, your family health history, and what tests are available in your area. You may have no tests, one test, or several tests.