Pregnancy in Older Women:  What are the Risks?

Maren Fuller, student midwife at Bastyr University

20130326_114033The age at which women give birth to their first baby has risen consistently over the last 30 years and more women are choosing to give birth past the age of 35 years (Ojule 2011).  Many recent clinical studies have looked at the safety and needs of women and babies in this special group.  It is important for midwives to know what extra support or preparation might be needed in order to care for older mothers in the safest in most effective way.

When compared with younger women, mothers over the age of 35 have elevated rates of gestational diabetes, chromosomal abnormalities, multiple gestation (especially twins), premature rupture of membranes and onset of labor, meconium in the amniotic fluid, low birth weight babies, and perinatal mortality (Jnifen 2010, Shoen 2009).  Older women can be offered screening for many of these complications or extra education so they are aware of the research and prepared to handle any of these situations that may arise.

On the positive side, women over the age of 35 have been shown to have protection from certain risks or complications of pregnancy.  Rates of cleft lip and cleft palate are lower in older women when compared to women in their 20’s (Martelli 2010).  Also, twins born to women over 35 have healthier birth weights and are less likely to be born prematurely (Delbaere 2008).  Perhaps most importantly, older women are more likely to be secure and stable in their relationships, careers and other areas that will positively affect the pregnancy and health of the child in the future.

Idaho’s midwifery statute does not regulate the age of women who can be cared for by midwives, as long as she does not have any other factors that require consultation with or transfer to another provider (Idaho Statutes 2008).  Since the age of mothers giving birth is rising every year, it is essential that midwives learn about the special needs of older women during pregnancy, birth and beyond.

REFERENCES:

Delbaere I, Verstraelen H, Goetgeluk S, Martens G, Derom C, De Bacquer D, De Backer G, Temmerman M.  Perinatal outcome of twin pregnancies in women of advanced age.  (2008)   Retrieved Feb 1, 2012 from: http://humrep.oxfordjournals.org/content/23/9/2145

Idaho Statutes, Title 54: Professions, Vocations and Businesses.  Chapter 55: Midwifery.  Retrieved Feb 1, 2012 from: http://www.legislature.idaho.gov/idstat/Title54/T54CH55SECT54-5505.htm

Jnifen A, Fadhlaoui A, Chaker A, Zhioua F.  Particularities of pregnancy and labor in 40-year-old women. Report of 300 cases. (2010)  Retrieved Feb 1, 2012 from: http://www.ncbi.nlm.nih.gov/pubmed/21049413

Martelli DR, Cruz KW, Barros LM, Silveira MF, Swerts MS, Martelli Júnior H. Cleft: Maternal and paternal age, birth order and interpregnancy interval evaluation for cleft lip-palate.  (2010)  Retrieved Feb 1, 2012 from: http://www.ncbi.nlm.nih.gov/pubmed/20339698

Ojule JD, Ibe VC, Fiebai PO.  Pregnancy outcome in elderly primigravidae. (2011)  Retrieved Feb 1, 2012 from: http://www.ncbi.nlm.nih.gov/pubmed/21912003

Schoen C, Rosen T. Maternal and perinatal risks for women over 44–a review. (2009)  Retrieved Feb 1, 2012 from: http://www.ncbi.nlm.nih.gov/pubmed/19822268

Maren Fuller is currently a student midwife, pursuing her master’s degree in midwifery at Bastyr University in Washington.  maren.fuller@bastyr.edu