Are women above age 35 more likely to have pregnancy complications?

Women in their late 30s and 40s are quite likely to have a healthy baby. However, they could face more complications than younger women. Some complications common in women over 35 include:

• Gestational diabetes: This kind of diabetes develops for the first time during pregnancy. Studies suggest that women above age 35 are twice as likely as younger women to develop gestational diabetes. Women with gestational diabetes are also more likely to have a very large baby. The baby is at risk of injuries during delivery and of newborn health problems (for instance, breathing problems).

• High blood pressure: As with diabetes, high blood pressure may develop for the first time during pregnancy, known as pregnancy-induced high blood pressure or pregnancy-induced hypertension. It is called preeclampsia when it is more severe.

• Placental problems: Placenta previa is the most common placental problem, in which the placenta covers part or all of the uterine opening (cervix). A study found that women in their late 30s were almost twice as likely, and women in their 40s nearly thrice as likely, as compared to younger women to have this complication. Placenta previa causes severe bleeding during delivery, endangering the mother and baby. A cesarean birth (c-section) often can prevent serious complications.

• Premature birth: Women aged 40 and above are more likely than women in their 20s and 30s to deliver prematurely (that is, before 37 completed weeks of pregnancy). Premature babies are at increased risk of a host of health problems in the newborn period as well as of lasting disabilities.

• Stillbirth: Stillbirth means death of the fetus after 20 weeks of pregnancy. A number of studies have shown that women over age 40 are about 2 to 3 times as likely as women in their 20s to have a stillborn baby. The causes of stillbirth in the over-40 age group are still not known.

How can a pregnant woman minimize her risks of pregnancy complications?

Today, many women in their late 30s and 40s can look forward to healthy pregnancies if they:

• Have a preconception checkup with their health care provider.
• Get early and regular prenatal care.
• Take a multivitamin having 400 micrograms of folic acid daily, starting before pregnancy and in early pregnancy, to help avoid neural tube defects.
• Begin pregnancy at a healthy weight (neither too heavy nor too thin).
• Don't drink alcohol.
• Don't smoke
• Don't use any drug, over-the-counter medications or herbs, unless recommended by your health care provider.
• Eat healthy foods, including foods that contain folic acid and folate like fortified breakfast cereals, beans, leafy green vegetables, enriched grain products, and orange juice.
• Don't eat undercooked meat or change a cat's litter box. Both are possible sources of toxoplasmosis, an infection that can cause birth defects.
• Don't eat fish that is high in mercury, like shark, king mackerel, swordfish, or tilefish.
• Get tested for immunity to rubella (German measles) as well as chickenpox before becoming pregnant. Also, consider being vaccinated if not immune. After being vaccinated, a woman needs to wait 1 month before getting pregnant.