Is is safe to be pregnant after 35?
While advances in medical care can help women over age 35 have safer pregnancies than in the past, health complications for this age group are higher than for younger women. If you have decided to delay having a child, you should understand the risks associated with this so you can take precautions to minimize risks and improve your chances for a healthy pregnancy and child.
Do I Have a Greater Risk of Having a Child With a Birth Defect if I'm Over 35?
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. 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 1 in 100 babies born with Down syndrome from women in their 40's.
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What Types of Prenatal Tests Should I Have if I'm Over 35?
Because women over age 35 are more likely to have certain problems during pregnancy, the following tests may be recommended. These tests can help detect disorders before, during and after your pregnancy. Some of these tests require appropriate genetic counseling, including a detailed discussion regarding the risks and benefits of the procedure(s). Whether you choose to have the tests is up to you. Talk to your health care provider to find out if any of these tests are right for you.
Ultrasound: a test in which high-frequency sound waves are used to produce an image of your baby. Ultrasound is used early in pregnancy to determine viability (if the baby is in the uterus and if the baby's heart is beating), the presence of more than one fetus, and to determine your baby's due date or gestational age (the age of the fetus). Later in pregnancy, ultrasound may be used to see how the baby is doing, to determine placenta location and the amount of amniotic fluid around the baby.
Quad Marker Screen: a blood test in which substances in the blood sample are measured to screen for problems in the development of the fetus' brain, spinal cord and other neural tissues of the central nervous system (neural tube) such as spina bifida or anencephaly. Neural tube defects occur in 1 or 2 out of every 1,000 births. The quad marker screen can detect approximately 75-80% of open neural tube defects.
The quad marker screen can also detect genetic disorders such as Down syndrome, a chromosomal abnormality. The quad marker screen can detect approximately 75% of Down syndrome cases in women under age 35 and over 80% of Down syndrome cases in women age 35 years and older.
The quad marker screen may be performed between the 15th and 20th weeks of pregnancy.
First Trimester Screen: A newer test done between weeks 10-14 detects the presence of 2 markers in a blood sample in conjunction with an ultrasound to measure the thickness of the back of the fetus' neck. It tests for chromosomal abnormalities, like Down syndrome. It is essentially as accurate as the quad marker screen but results can be obtained earlier in the pregnancy.
Amniocentesis: Amniocentesis is a procedure in which a small amount of amniotic fluid is removed from the sac surrounding the fetus and tested for birth defects. While it does not detect all birth defects, it can be used to detect sickle cell disease, cystic fibrosis, muscular dystrophy, Tay-Sachs disease or Down syndrome if the parents have a significant genetic risk.
Amniocentesis can also detect certain neural tube defects (where the spinal cord or brain don't develop normally) such as spina bifida and anencephaly. Because ultrasound is performed at the time of amniocentesis, it may detect birth defects that are not detected by amniocentesis (such as cleft palate, cleft lip, club foot or heart defects). There are some birth defects, however, that will not be detected by either amniocentesis or ultrasound.
Chorionic Villus Sampling (CVS): a test in which a small sample of cells (called chorionic villi) is taken from the placenta where it attaches to the wall of the uterus. Chorionic villi are tiny parts of the placenta that are formed from the fertilized egg, so they have the same genes as the fetus. If you have certain risk factors, you may be offered CVS as a way to detect birth defects during early pregnancy. CVS requires appropriate genetic counseling, including a detailed discussion regarding the risks and benefits of the procedure.
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