Ask the Doctor: Biggest worry for pregnant moms over 35?

April 21, 2011 12:00 AM

Q: What is the biggest worry for pregnancy over 35 and is there anything I can do about it other than worry?

A: OB/GYN doctors are seeing more and more pregnant patients over age 35 now than ever before.

Many females are delaying childbirth due to the demands of their career and education, especially in the big cities like New York. As women focus on careers, they often postpone building a family until they are over 30, but then finding someone to marry who is also interested in having children takes time. Many couples spend time together trying out their marriage before bringing a new life to this world and some prefer to wait until they are more financially stable.
As a woman gets older the chance of conceiving per cycle goes down.  In its peek at age 20 it is roughly at 25% per cycle. The risk of abnormal chromosome goes up and so is the risk of miscarriage. As we get older the risk of developing medical problems such as thyroid disease, hypertension, diabetes and other medical problems increases. These medical problems could increase the risk of pregnancy complications.

However the trough is that the majority of pregnancies for women over 35 go forward without any complications and almost all women do give birth to healthy children.  However there are a few precautions:
·      Start the pregnancy by planning ahead, do not drink alcohol or smoke, keep a healthy diet.
·      Try to start the pregnancy with ideal body weight; obesity increases pregnancy complications tremendously.
·      Start taking prenatal vitamins 3 month prior to conception and continue it throughout pregnancy and breastfeeding.
·      Taking folic acid supplementation prior to conception has been shown to decrease miscarriage and spina bifida
·      Omega 3 supplements improve fetal brain development and may also decrease preterm labor risk. They are also good for constipation.
·      Since down syndrome increases by maternal age, for patients over age 35 specially is very important to have a sonogram at 11-13 weeks of pregnancy to measure the embryo and nuchal thickness, together with a simple blood test from the mother about 75% of down syndromes are detected. This test will be followed in the second trimester between 15 to 20 weeks so called quad screen could detect 90% of chromosomal abnormalities.
·      A detailed anatomical sonogram should be performed at 16 and 21 weeks of pregnancy to make sure there in evidence of any structural abnormalities.
·      Chorionic villus sampling (CVS) or amniocentesis is offered to mothers over age 35 to detect fetal chromosomal incompatibilities with 99 to 100% accuracy.
·      Participating in childbirth preparation classes is important for the expecting couples.
·      Monitoring weight gain throughout the pregnancy is essential to avoid a big baby and therefore difficult deliveries.

Overall it is essential to have a good caregiver to take care of you through out pregnancy and address your concerns effectively.

The good news again, after all said and done, the majority of the mothers over age 35 do very well and have no major complications.

Dr. Roshan’s Bio:
Dr. Daniel RoshanDr. Daniel Roshan is a board certified OB/GYN who practices in New York.  Dr. Roshan specializes in high-risk pregnancies and Maternal-Fetal Medicine.  He was trained at John Hopkins hospital. You can find more about Dr. Roshan and his two medical practices at http://www.roshmfm.com/.

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