“Advanced Maternal Age” is the medical term that refers to a woman who will be 35 years of age or older when her baby is born. Due to career goals among other reasons, this is one of the fastest growing groups of first time mothers. Most of women who are 35 years or older will have perfectly normal pregnancies and healthy babies, and I would encourage any woman in this age group to pursue their childbearing plans. However, there are also several issues to be aware of.

One of the first things to consider is that fertility begins to decline when a woman is in her mid thirties, so it may be more difficult to become pregnant in the first place. Therefore, I would usually counsel these patients to come to the office for a consultation if they have not become pregnant after 6 months after trying on their own for evaluation and treatment.

Once pregnant, women over the age of 35 have higher incidence of several medical and pregnancy related disorders. Probably most well known is the higher risk of genetic/chromosomal abnormalities with the baby. This would include a slightly higher risk of Down’s syndrome. Again, most women in this age group will have perfectly normal babies, but the risk does increase by several percentage points.

Several screening methods exist that may detect such genetic abnormalities including ultrasound, amniocentesis, chorionic villus sampling (CVS), and blood tests such as the Quad Screen. However, none of these methods are 100% accurate and some may include risks to the baby.

There are other conditions that occur at a higher frequency including: high blood pressure, pre-eclampsia (“toxemia”), diabetes, premature labor, miscarriage as well as a higher chance of cesarean section. Interestingly, there is also a higher chance of fraternal (non-identical) twins; all of these conditions can be managed by a well trained obstetrician.

In summary, with more U.S. couples waiting longer in life to start a family a higher percentage of women will be in the advanced maternal age group. Although this is technically considered a high-risk pregnancy (for reasons previously discussed) the majority of women who have children after the age of 35 will have healthy babies and normal pregnancies. Therefore, these women should not be discouraged from following their childbearing plans, but should carefully plan with their physicians.