There are many reasons women may delay pregnancy. According to the American College of Obstetricians and Gynecologists, there is an upward trend in the average age of pregnant individuals worldwide.
Approximately 19% of all pregnancies and 11% of all first pregnancies are currently in those over age 35 in the United States. In 2020, the average age for first births was 27.1 years compared with 21.4 years in 1970.
If you are pregnant or planning a pregnancy over age 35, you may have many questions or concerns about pregnancy and childbirth.
Definition of geriatric pregnancy
We define advanced maternal age (formerly geriatric pregnancy) as those who are 35 years or older at their estimated delivery date. Historically, pregnancies at this age or older are considered at higher risk – for patient and fetus – for various reasons.
Increased risk factors for pregnancy at age 35 or older
While pregnancies at age 35 and older are considered high risk, not all will face the same challenges. Potential risks are on a continuum and increase with age. Medical studies divide these age ranges and their associated risks into five-year increments.
"At Nebraska Medicine, we look at age as only one component," says Teresa Berg, MD, Nebraska Medicine maternal-fetal medicine doctor. "We consider everything that may be going on in your life that could complicate your pregnancy and then make plans based on all the variables."
Increased risk factors exist for a variety of reasons, including:
- The development of age-related diseases, such as high blood pressure, obesity or diabetes
- As the number of eggs decreases with age, the remaining eggs are at higher risk of disorders that can affect fertility and chromosome abnormalities
- Lower fertility rate
Potential complications include an increased risk of:
- Gestational diabetes
- Cesarean delivery
- Preterm birth
- Miscarriage and stillbirth
- Fetal growth
- Chromosomal abnormalities and congenital malformations
- Multiple pregnancies (twins)
- Preeclampsia, especially over age 40
Pregnancy care over 35: What to expect
What to expect for pregnancy care and screening depends on your age, health history, and other factors. Your doctor will consider all risk factors when developing your individualized care plan.
Depending on your situation, expect to discuss:
- Ultrasounds: At a minimum, one in the first trimester, one at 20 weeks, and one in the third trimester (detailed ultrasonogram). Women over 40 with risk factors may receive ultrasounds every 4 to 6 weeks
- Potential prenatal DNA screening, genetic counseling or diagnostic testing
- Antenatal fetal surveillance: tracing heart rate, fetal activity and amniotic fluid (once or twice per week)
- Preferences for labor and delivery
- If you have two or more risk factors, your doctor will most likely recommend daily, low-dose aspirin to reduce the risk of preeclampsia
"Although there is an increased risk at or over age 35, we still see the majority of women deliver at term with babies that thrive," says Dr. Berg. "There are more decisions to be made, but typically these women approach with the readiness and education they need to start or expand their family."
Preparing for your pregnancy
If you're planning a pregnancy over age 35, look closely at your current health and any medications you are taking. If you have a chronic health problem, address it with your doctor. Ask them how you could make pregnancy safer and healthier.
"We support our patients by treating the whole person," adds Dr. Berg. "We discuss not only all physical aspects but also things like their support system and mental health. We walk them through what to expect at every stage of pregnancy and guide them through it."
Tips to keep in mind:
- Unless you have a chronic illness or a medical condition, you may not need to see a maternal-fetal medicine specialist. It is common to stay with your obstetrician and only consult with a high-risk specialist if and when needed
- If you're at risk of early delivery, try to get your house ready earlier to feel prepared
- If or when complications occur, know that there is nothing you did (or didn't do) that caused them
- Consider attending one of our childbirth education classes and pregnancy and postpartum support groups
Nebraska Medicine Olson Center for Women's Health has a team of maternal-fetal medicine specialists with specialized expertise in managing high-risk pregnancies. If you're new to Nebraska Medicine and need to schedule a new pregnancy appointment, please call 402.559.4500.
FAQs
Pregnancies have an increased risk for certain complications when the birth parent is 35 or older. Some of these complications are higher rates of miscarriage, genetic disorders, and certain pregnancy complications like high blood pressure or gestational diabetes.
What is considered high risk pregnancy? ›
A high-risk pregnancy is one in which a woman and her fetus face a higher-than-normal chance of experiencing problems. These risks may be due to factors in the pregnancy itself, or they may stem from preexisting maternal medical conditions, such as cancer, diabetes, or lupus.
How much riskier is geriatric pregnancy? ›
The risk of miscarriage and stillbirth in women over the age of 35 is higher than in women of childbearing age. The risk of miscarriage when a woman is 35 years old is 20%, this rate also increases with the age of the mother, women aged 45 have a high risk of miscarriage up to 35%.
Is having a baby at 36 years old safe? ›
Babies born to older mothers have a higher risk of certain chromosomal conditions, such as Down syndrome. The risk of pregnancy loss is higher. The risk of miscarriage and stillbirth increases with age. This may be because of preexisting medical conditions or because of chromosomal conditions in the baby.
Is 34 too old to have a baby? ›
If you are thinking about having a baby in your late thirties or early forties, you are not alone. Women ages 35-45 are increasingly becoming first-time moms. And most healthy women in this age group have healthy pregnancies, births and babies.
Which pregnancy category is considered the riskiest? ›
Category X
Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use of the drug in pregnant women clearly outweigh potential benefits.
What age should you stop having kids? ›
By age 30, fertility (the ability to get pregnant) starts to decline. This decline happens faster once you reach your mid-30s. By 45, fertility has declined so much that getting pregnant naturally is unlikely.
Are geriatric pregnancies harder? ›
Age does matter when it comes to having a baby. Apart from taking longer, on average, to get pregnant in the first place, older moms are more likely to have a miscarriage or stillbirth , and there are also increased health risks to both mom and baby.
What is the prime age for a woman to have a baby? ›
Experts say the best time to get pregnant is between your late 20s and early 30s. This age range is associated with the best outcomes for both you and your baby. One study pinpointed the ideal age to give birth to a first child as 30.5. Your age is just one factor that should go into your decision to get pregnant.
What maternal age is high risk? ›
If you're 17 years old or younger or 35 years old or older, your pregnancy could generally be considered "high-risk." Women tend to have a window of time when it's easier on their body to grow a baby and give birth.
Pointing to the question, “Does folic acid prevent Down Syndrome?”, researchers indicate that folic acid intake may help lower the risk of developing Down syndrome, despite the fact that it is a genetic disorder that cannot be treated.
What are the odds of Down syndrome at 36? ›
Down syndrome occurs in people of all races and economic levels. The risk increases with the mother's age (1 in 1250 for a 25 year old mother to 1 in 1000 at age 31, 1 in 400 at age 35, and about 1 in 100 at age 40).
Why is 35 considered an advanced maternal age? ›
Chronic medical disorders such as obesity, hypertension, and diabetes are more prevalent in pregnant individuals aged 35 years and older.
What age is considered an old mom? ›
Advanced maternal age is basically a fancy way of saying pregnant at 35 or older. Keep in mind, though, that even if you're not 35, you may still be considered of an “advanced” age by the standards associated with various pregnancy risks.
What is the oldest age a woman can get pregnant naturally? ›
As you get older, the number of eggs you have decreases. They are also more likely to have abnormalities. Additionally, the older you are, the more likely you are to develop disorders that can make you less likely to get pregnant, such as endometriosis. By the age of 45, you're not likely to get pregnant naturally.
Does having a baby age you? ›
But does being pregnant actually take years off your life? According to the results of a new study, it just might. Today in Cell Metabolism , scientists report that the stress of pregnancy can cause a person's biological age to increase by up to 2 years—a trend that may reverse itself in the months that follow.
What is a high risk score in pregnancy? ›
Thus, the risk scale was refined as <12 indicating low risk, between 12 and 14 as moderate risk, and ≥15 as high risk [Table 4]. This higher cutoff value of ≥15 had a sensitivity of 74.6% and specificity of 99.4% and positive predictive value of LBW of 98.1%.
What is considered a high chance of pregnancy? ›
You're most fertile at the time of ovulation (when an egg is released from your ovaries), which usually occurs 12 to 14 days before your next period starts. This is the time of the month when you're most likely to get pregnant.
What is a high-risk pregnancy class? ›
High Risk Pregnancy
- Age – less than 15 or more than 38 years.
- Weight – weight under 100 lb before pregnancy or overweight.
- Height – under five feet.
- Difficult pregnancies in the past.
- Chronic medical conditions such as diabetes, high blood pressure.
- Family history of genetic conditions.
- Rh incompatibility.
- Multiple pregnancy.
In the United States, birth rates for women in their 30s are at the highest levels in three decades. However, an older mother may be at increased risk for miscarriage, birth defects, and pregnancy complications such as twins, high blood pressure, gestational diabetes, and difficult labors.
