Geriatric Pregnancy: Embracing Your Motherhood

If you're over 35 and expecting a baby, chances are your doctor will describe you as an advanced maternal age mother (previously known as a geriatric pregnancy). The term was once associated with older pregnancies, but nowadays, it can mean decades of wisdom and preparation for motherhood.

It's understandable if mums-to-be are worried about having a baby at this age; however, with proper care and support, you too can welcome a new addition to the family!

What is a geriatric pregnancy?

“Geriatric pregnancy” is an outdated term that refers to a pregnancy occurring when the mother is over 35 years old at the time of delivery. The term has been changed to "advanced maternal age" (AMA) due to the increasing number of first- or second-time mothers giving birth between the ages of 35 and 39.

But why is the term AMA still used if pregnancy after 35 isn’t that unusual? It's because your chances of experiencing complications and other risks during pregnancy are higher after 35. So the term means that you'll receive enhanced monitoring and care to ensure the best possible outcomes for you and your baby.

This doesn't mean there's anything wrong – it just means you'll receive more attention during your pregnancy. Think of it as receiving exclusive healthcare that gives you the best possible chance of a successful pregnancy.

What are the potential risks of a geriatric pregnancy?

While all pregnancies carry some risk, the likelihood of complications increases with age. This is because egg quality declines with age, making it more likely that an embryo will have genetic (chromosomal) anomalies.

Additionally, after the age of 35, the likelihood of developing chronic medical conditions that can affect pregnancy and delivery increases. Some of the risks associated with advanced maternal age during pregnancy include:

• Higher risk of gestational (pregnancy) diabetes

• Increased risk of fibroids and endometriosis

• Elevated risk of miscarriage compared to younger pregnancy

• Increased risk of multiple pregnancy, due to hormonal changes causing the release of more than one egg

• An increased chance of chromosomal abnormalities, such as Down's syndrome, due to age-related changes in egg quality

• Increased risk of placenta praevia (when the placenta blocks the birth canal), placental abruption (when the placenta detaches too early), and premature birth

However, some risks increase significantly after the age of 40, such as preeclampsia, which is characterised by high blood pressure and high levels of protein in the urine (proteinuria), indicating kidney damage.

How does geriatric pregnancy affect labour and delivery?

During an AMA pregnancy, labour and delivery may present additional challenges. Mothers are more likely to experience difficulties, such as prolonged labour, slower cervical dilation, and ineffective uterine contractions.

Consequently, natural labour can be difficult, resulting in a higher rate of caesarean section (C-section) deliveries. Additionally, maternal medical conditions such as hypertension or diabetes may influence the choice of delivery method and timing, as doctors may recommend early induction or a planned C-section for safety reasons.

However, careful monitoring during labour and appropriate medical interventions mean that, even with these challenges, you can still have a safe and positive delivery experience during an AMA pregnancy.

If you're currently in an AMA pregnancy and are worried about the health of your baby or anxious about childbirth, you don't have to carry these concerns alone. Schedule an appointment with Thomson Women's Clinic, where our O&G specialists understand what you're experiencing and can help provide personalised and empathetic care you deserve.

How can I increase my chances of having a healthy baby if I have a geriatric pregnancy?

If you're in an advanced maternal age (AMA) pregnancy, there are some proactive steps you can take before and during pregnancy to improve your chances of having a healthy baby. Here are some tips you can try to help you have a successful pregnancy:

• Undergo genetic testing:

  • During pregnancy, you can undergo cell-free foetal DNA (cffDNA) testing, which checks for certain conditions in your baby, including Down syndrome, and trisomy 13 and trisomy 18.

  • Other tests you can consider are amniocentesis and chorionic villus sampling, to spot certain genetic disorders.

  • Another type of test is the quad screen, or quad marker screen, performed between 15 and 22 weeks, which includes tests for four substances in your blood, AFP (alpha-fetoprotein), hCG (human chorionic gonadotropin), oestriol (a type of oestrogen), and inhibin-A.

  • If you have too much or too little of some of these substances, it may indicate increased risk for Down syndrome, trisomy 18, and neural tube defects. The quad screen is a simple blood test and safe for you and your baby.

• Taking a prenatal test:

  • Screening for chromosomal abnormalities, such as first-trimester combined screening, which uses ultrasound and blood tests, or non-invasive prenatal testing (NIPT), which analyses cell-free foetal DNA in your blood, helps detect potential complications early.

  • Pelvic ultrasound can also be performed to evaluate foetal anatomy and growth, as the risk of congenital anomalies is slightly higher in mature mothers.

  • Your doctor may also check your blood pressure, test your urine for protein and sugar, and test your blood glucose levels to prevent gestational diabetes, preeclampsia, and anaemia.

• Maintain an ideal body weight:

  • Being either overweight or underweight can cause pregnancy complications. So it's recommended that you maintain an ideal body weight with a range between 18.5 and 24.9 on the BMI scale.

  • Weights above 24.9 are considered overweight, with a scale exceeding 30 indicating obesity, while those below 18.5 are classified as underweight.

• Exercise regularly:

  • To maintain an ideal body weight and help maintain a healthy pregnancy, it's recommended that you regularly engage in mild exercises, such as regular walking, yoga, and cycling.

• Reduce alcohol intake and quit smoking:

  • To maintain your pregnancy health, it is recommended that you limit your intake of harmful chemicals and stimulants, such as nicotine, caffeine, and alcohol.

• Taking a prenatal vitamins:

  • To help increase the success of an AMA pregnancy, you can consider taking a daily prenatal vitamin with at least 400 micrograms of folic acid to help prevent  abnormalities in your baby's brain and spinal cord.

  • However, don't take more than 1,000 micrograms (1 milligram) of folic acid without asking your doctor.

• Consume well-balanced, nutritious food:

  • Routinely consuming a well-balanced diet, including food that is rich in antioxidants and omega-3 fatty acids, could increase your chances of having a healthy pregnancy.

  • Consider routinely consuming foods such as chicken, lean cuts of beef, salmon, oats, spinach, strawberries, walnuts, and almonds.

• Manage stress:

  • Create a calm, stress-free environment, as stress can affect your hormonal balance and menstrual cycle. High cortisol levels caused by stress can disrupt key reproductive hormones like oestrogen and progesterone.

  • To maintain your mental health, practise stress management techniques, such as building a good social support system and practising mindfulness, meditation, or breathing exercises.

  • You should also aim for 7-8 hours of restful sleep each night. A good night's sleep can reduce stress and support your overall physical, mental, and reproductive health.

Along with routine scans, these simple pregnancy tips can also help you feel more confident and supported throughout your journey.

Recovering and healing after a geriatric pregnancy

If you are of advanced maternal age, your recovery after childbirth may take longer than that of younger mothers. This phenomenon is because the natural healing and energy recovery processes are influenced by age, and more mature women may experience greater fatigue and a slower return to their pre-pregnancy level of physical fitness.

This is especially true if you've had a caesarean section, as this necessitates a longer recovery period due to the surgical healing process.

More mature mothers may also be at slightly increased risk of post-birth complications, such as infections, blood clots, or delayed wound healing. Emotional and psychological recovery is equally important, as mothers may feel additional stress when balancing motherhood with other life responsibilities.

However, with effective postnatal care, adequate rest, a nutritious diet, family support and regular check-ups with healthcare providers, you can make a full recovery and go on to enjoy healthy lives with your little angel.

Our O&G specialists understand what you're experiencing and can provide the personalised, empathetic care you deserve during an advanced maternal age pregnancy. Schedule an appointment with Thomson Women's Clinic today.

FAQ

Are there any benefits of conceiving late?

How does pregnancy change after 35?

Is there any way I can lower my risk of pregnancy problems if I have a geriatric pregnancy?

Is 40 too late to have a baby?

Not necessarily. Many mothers successfully conceive and give birth to healthy babies in their forties, particularly with fertility treatment if natural conception proves difficult. With proper preconception counselling, a healthy lifestyle, and close monitoring, pregnancy at 40 can be both safe and fulfilling.

What are the odds of conceiving a child with Down syndrome at 37?

What is the oldest age to have a baby?

The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations and tailored advice, schedule an appointment at Thomson Women’s Clinic.