Let’s talk a little bit about “Geriatric Pregnancy.” The feature image of this post epitomizes the look on any woman’s face when the pregnancy test unexpectedly turns positive. Disbelief. The most “seasoned” woman I have personally ever diagnosed with a spontaneous pregnancy was 47. She looked GOOD though. I remember thinking, “I want to be like YOU when I grow up!” Hold up… I wanted to be like her in regards to her youthful face, not her forty-something unexpected pregnancy. I have all of the babies I want already.
This post is for the women who are, or will be 35 or older when they plan to have children – previously referred to as geriatric pregnancy. Thanks to the character, Kate, from This Is Us, I have heard the term, geriatric, more often in the last 2 weeks than I had in the past year. We progressive OB/GYNs don’t call women her age (37) geriatric, elderly or old. The current and proper term for a woman who is 35 or older at the time of delivery is Advanced Maternal Age.
See how much nicer that sounds?
What exactly does Advanced Maternal Age, or “Geriatric pregnancy” mean and can you, as old as you are, still have a baby? #Whatdidshejustsay?
Well, it can mean a few things. On the fertility side, it can mean that a woman can have more of a challenge getting pregnant.
But wait, fertility doesn’t fall off of a cliff when you turn 35. From the time that we start our menstrual cycles, our fertility slowly and steadily decreases. Women are most fertile in their late teens and early 20s, but then every year fertility steadily declines. At 35, the fertility curve slope changes a bit. For the mathematicians in the house, it goes from a somewhat linear curve to a more exponential one. For the non-mathematicians, that just means that the line gets steeper and your chances of NOT getting pregnant go up more rapidly.
As you can see in this graph, a 36-year-old is only slightly less fertile than a 35-year-old, who is slightly less fertile than a 34-year-old. All of those chicks are less fertile than a 25-year-old. The point is, the situation is constantly changing and there is no magic about 35, other than the decline speed changes and it becomes more clear that fertility is not eternal.
Women who are older at the time of conception do carry an increased risk of having a baby with a chromosomal abnormality. This is because as our eggs age, they become more likely to malfunction. If an egg malfunctions and ends up with the wrong number of chromosomes, the resulting fetus may be more likely to miscarry or be abnormal.
How high are your chances of having a baby with a birth defect?
I am all about the graphs in this post.
As you can see, a 20-year-old has less than a 1 percent chance of having a baby with Down syndrome. At 35, the risk is still less than 1 percent, though it has increased. By 45, the risk is now over 3%, but that still means that 96 out of 100 women who get pregnant at the age of 45 will NOT have a baby with Down syndrome. There are more chromosomal abnormalities than just that one, but the point that I am making is that being over 35 DOES NOT predestine you to having a baby with a congenital (from birth) health challenge, any more than being under 35 guarantees that you won’t.
I should add that the stats for birth defects apply to live births at the above ages. Many eggs and sperm have genetic abnormalities that lead to infertility, decreased fertility, or early miscarriage. Most babies that make it to being born on time, or on time-ish, will be normal, genetically.
Of the few babies who I have delivered with birth defects, most have been with women who were under 35. This is because the volume of women having babies under 35 is higher. Even though the risk of abnormal chromosomes is less likely, I see higher volumes of women so I inevitably encounter these abnormalities from time to time.
What can you do to maximize your fertility and your chances of having a baby without chromosomal abnormalities?
Age is the biggest factor when it comes to fertility and the risk of chromosomal abnormalities. Check out our post about Egg Preservation if you know that your eggs aren’t going to be put in the game anytime soon.
Egg: “Put me in the game, Coach!”
Since your age is out of your control, being as healthy as possible is key. Achieving a healthy weight, eating a diet rich in antioxidants, and avoiding things like smoking and excessive alcohol are important. If you are looking for a place to learn more about healthy eating and nutrition, check out thedocskitchen.com.
There is also a great post on The Doc’s Kitchen about sperm quality and fertility as they relate to nutrition. Check that out.
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Categories: B-LOGIC, GYN, OB, Uncategorized
Awesome post! Thank you! Loved it.
Hi Dr McDonald! You delivered my beautiful, healthy, ten pound daughter six years ago when I was 44. She is still beautiful and healthy and smart as a whip and running her 50 year old mama ragged! 🙂