Things to keep in mind when planning pregnancy after 35

Things to keep in mind when planning pregnancy after 35

In the present day, more and more women want to focus on peaking in their career before embarking on wedding and childbearing. We currently see more women marrying past 35 years and getting into parenthood around 40 years.

Medical science has advanced, but no technology can prevent the biological ageing that all cells undergo. Girls are born with a fixed number of primordial follicles which begin to get depleted even before birth and continue to decline till the egg reserve is depleted. The reproductive potential begins to decline after the age of 37 years. Theoretically,a woman, a woman can get pregnant any time before she hits menopause, around 52 years.

Once pregnancy is achieved, medical experts counsel women to celebrate only after 12 weeks as about 20 percent of pregnancies can land up with a miscarriage. As age advances, the chance of miscarriage increases. After 40 years of age, the miscarriage rates are around 50 percent.

The bigger concern which affects women getting pregnant past 40 years is a fear of harbouring a down syndrome baby. Down syndrome is a chromosomal aberration in chromosome number 21 where the chromosomes can be in three sets rather than two. These children have mental retardation and can have cardiac defects as well. Advances in fetal medicine have helped identify Down syndrome and once detected, couples can choose to terminate if they do not want to go ahead. There are different tests available for detecting Downs syndrome. They include NT scan, double marker test and NIPT. All these tests have some false negativity rate. If a woman wants to be sure that she is not harbouring a Downs syndrome, she may have to go through an invasive procedure called ‘amniocentesis’, where fluid around the baby is removed and chromosomes analysed. Though this test has a very high sensitivity, there is a one in 200 chance of a miscarriage which can be devastating for the couple who are already at the brink of the obstetric career.

Women over 35 years tend to have a slightly higher incidence of diabetes and hypertension in pregnancy. So, they need to be regular with the antenatal check-ups. It is essential for women over 35 who are getting pregnant to be in an optimum state of health. To ensure this, one needs to ensure women maintain their weight, do regular physical activities and do not indulge in smoking or drinking.

To summarise, women need to understand that the eggs in the body are fixed and keep depleting with each period and hence, the need to finish childbearing is vital. Besides there is no guarantee that all pregnancies end up with taking a baby back home. With each miscarriage, stress mounts which can interfere with conception eventually.

Good news to all is that women who are considering pregnancy after 35 can and will have a good outcome. Remain in a positive state of mind, be physically active and partake a well-balanced diet. Embark on pregnancy with an optimum weight and take each month as it comes.

Dr Gayathri D Kamath

Senior Consultant - Obstetrics & Gynaecology, Fortis Hospital, Bannerghatta Road

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