Complications of Pregnancy for a Woman Over Age 35

‫ ڿ‬Pregnancy-Induced Hypertension
A woman over age 40 may have higher incidence of pregnancy-
induced hypertension than a younger woman, possibly related to blood
vessel inelasticity or because hypertension tends to occur more
frequently in nulliparas than multiparas or those with already elevated
blood pressure. At any age, the best way to reduce symptoms of
pregnancy-induced hypertension is for a woman to rest for a good
portion of each day.

‫ ڿ‬Complications and Concerns of Labor, Birth and the

Postpartum Period
a. Failure to Progress in Labor
Labor in older primipara may be prolonged because cervical
dilatation may not occur as spontaneously as in a younger
woman, probably because of decreased elasticity in cells.
Graphing labor progress is a very good method to use to
determine when labor is becoming prolonged. Many women
this age may need a cesarean birth if labor is overly
prolonged and places the fetus at risk.
b. Postpartum Hemorrhage
Just as the cervix may not dilate as readily during an older
woman’s labor, the uterus may not contract as readily in the
postpartum period due to inelasticity. Therefore, an older
woman is at higher risk for postpartum hemorrhage.

Other Complications
Although the pregnancy rate among women over thirty-five has nearly
doubled, the risks associated with pregnancy increase gradually as age
advances. Women over 35 have a slightly increased risk of the
following complications during pregnancy:

‫ ڿ‬miscarriage : for women at age 40, the risk is about 25 percent

Studies show that the risk of miscarriage (loss of a pregnancy
before 20 weeks gestation) is 12% to 15% for women in their 20s
and rises to about 25% for women at age 40. The increased
incidence of chromosomal abnormalities contributes to this
increased risk of miscarriage in older women.
‫ ڿ‬placenta previa : this can cause excessive bleeding during
delivery; often a cesarean section is needed
‫ ڿ‬fetal distress : fetal distress and prolonged labor are more
likely if this is a woman’s first pregnancy
‫ ڿ‬low birthweight baby : Older women are also more likely to
have low-birth weight babies (weighing less than 5.5 pounds at
birth). The likelihood of a low birthweight baby (less than 5-½
pounds) or a preterm birth (less than 37 weeks of pregnancy)
can be significantly reduced by not smoking during pregnancy.
‫ ڿ‬stillbirth (delivery of a baby that has died before birth) is more
common in women over age 35.
‫ ڿ‬cesarean birth : women over 35 have a greater chance of
having a cesarean delivery than do other women
‫ ڿ‬Down syndrome : the incidence of Down syndrome increases
from 1 in 10,000 for 20 year old mothers to about 3 in 1,000 for
35 year old mothers and 1 in 100 for 40 year old mothers; this
 may be due to the fact that an older woman’s eggs have been
exposed to more x-rays, drugs and infections than a younger
woman’s eggs. Down syndrome isn’t preventable, but it can be
identified before birth during a prenatal exam.
The risk of giving birth to a child with a birth defect does increase as
the mother's age increases. This is probably due to abnormal
division of the egg, called nondisjunction. This leads to unequal
chromosomes at the end of division. The traditional age at which a
woman is considered to be at high risk for chromosomal
abnormalities is 35. Approximately 1 in 1,400 babies born from
women in their 20's have Down syndrome; it increases to about 1 in
100 babies born with Down syndrome from women in their 40s.
‫ ڿ‬high blood pressure : an older woman is more likely to develop
high blood pressure, diabetes, or cardiovascular disease during
pregnancy. These conditions are all controllable by your doctor
during your pregnancy.

Tips for Older Moms

Good health prior and during pregnancy will help you reduce your risk
of complications. Here are some general recommendations.

‫ ڿ‬Be sure to get enough folic acid in your diet. The current
recommendation for women of childbearing age is to take a daily
supplement containing at least 0.4 mg. of folic acid, in addition
to consuming foods naturally rich in folic acid. Folic acid is
naturally contained in leafy green vegetables, dried beans, liver
and some citrus fruits.
‫ ڿ‬Limit your caffeine consumption. Do not have more than 300 mg.
of caffeine per day. The caffeine content in various drinks
depends on the beans or leaves used and how it is prepared. An
8-ounce cup of coffee has about 150 mg on average while black
tea has about 80 mg of caffeine. A 12-ounce glass of caffeinated
soda contains anywhere from 30-60 mg of caffeine. Remember,
chocolate contains caffeine -- the amount of caffeine in a
chocolate bar is equal to 1/4 cup of coffee.
‫ ڿ‬Maintain a healthy, well-balanced diet and eat a variety of foods
to get all the nutrients you need. Choose foods high in starch and
fiber. Make sure you are getting enough vitamins and minerals in
your daily diet. Eat and drink at least 4 servings of dairy products
and calcium-rich foods a day, choose at least one source each of
Vitamin C, Vitamin A and folic acid every day.
‫ ڿ‬Exercise regularly. Review your exercise program with your
health care provider. Generally, you may continue your normal
exercise routine throughout pregnancy unless you are instructed
to decrease or modify your activities.
‫ ڿ‬Don't drink alcohol during pregnancy and don't use any
medications unless recommended by your doctor.
‫ ڿ‬Don't smoke during pregnancy.

In addition, be sure to obtain prenatal care, especially early in your

pregnancy. The first eight weeks are especially critical in your baby's
development. Early and regular prenatal care (health care during
pregnancy) can increase your chances of having a healthy baby.
Regular appointments with your health care provider throughout your
pregnancy are important to monitor your health and prevent or control
any problems that develop during pregnancy. In addition to medical
care, prenatal care includes education on pregnancy and childbirth,
plus counseling and support.