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Pregnancy over 40
 
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The real risks of first-time pregnancy after 40

Pursuing studies, a career, a home… these are among the various reasons that more and more women postpone pregnancy and end up trying for their first child after 35, or even after 40.

Late pregnancy risks
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An increasing number of women are becoming pregnant after 40. In England and Wales combined, some 26,976 babies were born to women aged over 40 in 2009, as compared with 9,336 in 1989 and 14,252 in 1999. Despite medical advances, such late pregnancies are not necessarily optimal. So what are the actual risks of middle-age pregnancy? How can you improve your chances of delivering a healthy child?

There is one very important thing to bear in mind: if you want to get pregnant, don’t wait!

Challenging preconceived ideas on late-age pregnancy

Often, women who whish to get pregnant in their 40s are made to feel guilty and worried. “People tell them that their child is more liable to have a deformity, which is not true!” exclaims Pr Michel Tournaire, an obstetrician at the Saint-Vincent de Paul hospital in Paris, France.

While it’s true that chances of having a child born with Down’s syndrome are much higher, screening is now systematically suggested to pregnant women over 38. The risk of giving birth to a child with Down’s syndrome can therefore be avoided if the patient is willing to accept medical pregnancy termination. Risks for the child to develop other deformities aren’t as high, however.

Pregnancy over 40 should not pose any additional risks if patients are more closely monitored. In this way, conditions that are more likely to develop in middle-aged women, such as hypertension, gestational diabetes and fibroma can be detected and treated.

Risks to children born to women over 40 include preterm birth, which is slightly more common in middle-aged women especially in cases of in vitro fertilisation. The most substantial risk is twin pregnancy, which causes higher childbirth mortality rates among women aged 40 and more, though figures remain relatively low. It is worth noting, too, that middle-age pregnancy causes more fatigue to mothers.

One very real risk with late-age pregnancy

The real risk of wanting to get pregnant late in life is, well... simply never to get pregnant. Fertility plummets from age 35 onward, as explained by Dr Joëlle Belaïsch-Allart, head of the gynaecology-obstetrics department of the Jean Rostand de Sèvres hospital near Paris, France.

“Women shouldn’t be misled into believing that they can conceive a child whenever they please, especially not after 40. Over 45, the likelihood of falling pregnant is close to zero.” She goes on to say that “just because you still have your periods doesn’t mean you’re still as fertile. Besides, in vitro fertilisation isn’t some kind of magic wand  that you just wave and get pregnant”.

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Posted 19.07.2010

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