1. Some Pregnancy Problems in Older Women
Problems healthcare providers see more
often in older pregnant women include gestational diabetes, high blood
pressure, placental problems, more miscarriages, more Cesarean births
and a slightly higher risk of giving birth to a baby with genetic or
chromosomal abnormalities.
Beginning in their late 30s, women are
more likely to develop medical conditions associated with reproductive
organs, such as uterine fibroids and muscle tumors, which may cause
pain or vaginal bleeding as pregnancy progresses. After 40, a woman may
feel the physical strains of pregnancy more. She may be more bothered
by hemorrhoids, incontinence, varicose veins, vascular problems, muscle
aches and pains, back pain and a harder, longer labor.
Two serious pregnancy risks increase for
women in their 40s—miscarriage and birth of a child with Down syndrome.
Miscarriage ends about 40% of pregnancies in women who get pregnant
after age 40.
The national average for Cesarean
deliveries is over 30%, and the rate rises with age. The
Cesarean-delivery rate for pregnant women between 40 and 54 years old
is nearly double the rate for women younger than 20.
The risk of a pregnancy ending in
stillbirth (the baby is dead upon delivery) has fallen for women of all
ages in recent years. For a mother older than 35, the risk is about 7
in 1000. The risk of some birth defects does not increase for older mothers.
2. Genetic Counseling
If you are older than 35, your
healthcare provider may recommend genetic counseling for you and your
partner. Healthcare professionals interpret information gathered from
interviews, tests and health histories, then share the results with you
both.
Genetic counseling seldom provides exact
information. Counselors describe information in terms of percentages
and odds. No one will tell you what to do; they provide you with
information and support so you can make your own decisions.
Counseling can help
you and your partner understand your current situation, its diagnosis
and prognosis. It can help you in family planning and provide support
to you and your family. Counselors can help you explore options for the
present and future.
Genetic counseling is a complicated
process and requires input from several different professionals. These
professionals can include a medical geneticist, genetic counselor,
social worker, psychologist or psychiatrist, laboratory specialists,
clergy, parent groups and others.
Ask your genetic counselor any questions
you have about the information you are given. This person can help you
understand and use the resources available and help you understand what
is involved in making important decisions.
Time-Saving, Energy-Saving Tip
As we age, it’s important to take care
of our skin. Being an older pregnant woman means this task may be even
more important to you. Try the following tips for healthy skin. Wear
lots of sunscreen—a moisturizer with sunscreen is a good choice even if
you do wear makeup. A facial can help with puffiness, or put slices of
cold cucumbers on your closed eyelids to reduce swelling. If you wear
makeup, remove it every night before bed, even if you’re exhausted.
Then wash your face and apply moisturizer.
As information is gathered, it may be
necessary to share it with other members of your family. If a gene
abnormality is identified, your sister, for example, will probably want
to know about it before she starts her own family.
In the past, genetic counseling
was offered only to older women or after the birth of a child with a
defect. With increased awareness and advances in technology, today we
can provide couples with information before conception. The three major
areas we focus on are reproductive history, family history and
consanguinity (partners are related).
3. When to Seek Genetic Counseling
Genetic counseling is advised in a number of situations:
•either partner has a family history of birth defects, mental retardation, chromosome abnormality or neurological disorders
•either partner has a family history of neural-tube defects (such as spina bifida)
•the couple has previously given birth to a child with a chromosomal abnormality
•either partner has a chromosomal abnormality
•the woman is a carrier of a sex-chromosome disorder
•the woman will be 35 or older at the time of birth
•the woman has had three or more miscarriages
•the woman has been exposed to teratogens (environmental factors harmful to the fetus)
•with consanguinity (couple is related)
•either partner is in a high-risk ethnic group
