Safe Pregnancy After Age 35

Women who become pregnant after the age of 35 have a higher risk for certain problems during pregnancy. This is because older women may already have health problems before becoming pregnant.

Older women who are healthy before pregnancy may still develop problems during pregnancy. These problems may affect the mother, the unborn baby (fetus), or both.

What are the risks for me?

If you are over age 35 and you want to become pregnant or are pregnant, you may have a higher risk of:

• Not being able to get pregnant (infertility).
• Going into labor early (preterm labor).
• Needing surgical delivery of your baby (cesarean delivery, or C-section).
• Having high blood pressure (hypertension).
• Having complications during pregnancy, such as high blood pressure and other symptoms (preeclampsia).
• Having diabetes during pregnancy (gestational diabetes).
• Being pregnant with more than one baby.
• Loss of the unborn baby before 20 weeks (miscarriage) or after 20 weeks of pregnancy (stillbirth).

What are the risks for my baby?

Babies born to women over the age of 35 have a higher risk for:

• Being born early (prematurity).
• Low birth weight, which is less than 5 lb, 8 oz (2.5 kg).
• Birth defects, such as Down syndrome and cleft palate.
• Health complications, including problems with growth and development.

How is prenatal care different for women over age 35?

All women should see their health care provider before they try to become pregnant. This is especially important for women over the age of 35. Tell your health care provider about:

• Any health problems you have.
• Any medicines you take.
• Any family history of health problems or chromosome-related defects.
• Any problems you have had with past pregnancies or deliveries.

If you are over age 35 and you plan to become pregnant:

• Start taking a daily multivitamin a month or more before you try to get pregnant. Your multivitamin should contain 400 mcg (micrograms) of folic acid.

If you are over age 35 and pregnant, make sure you:

• Keep taking your multivitamin unless your health care provider tells you not to take it.
• Keep all prenatal visits as told by your health care provider. This is important.
• Have ultrasounds regularly throughout your pregnancy to check for problems.
• Talk with your health care provider about other prenatal screening tests that you may need.

What additional prenatal tests are needed?

Screening tests show whether your baby has a higher risk for birth defects than other babies. Screening tests include:

• Ultrasound tests to look for markers that indicate a risk for birth defects.
• Maternal blood screening. These are blood tests that measure certain substances in your blood to determine your baby’s risk for defects.

Screening tests do not show whether your baby has or does not have defects. They only show your baby’s risk for certain defects. If your screening tests show that risk factors are present, you may need tests to confirm the defect (diagnostic testing). These tests may include:

• Chorionic villus sampling. For this procedure, a tissue sample is taken from the organ that forms in your uterus to nourish your baby (placenta). The sample is removed through your cervix or abdomen and tested.
• Amniocentesis. For this procedure, a small amount of the fluid that surrounds the baby in the uterus (amniotic fluid) is removed and tested.

What can I do to stay healthy during my pregnancy?

Staying healthy during pregnancy can help you and your baby to have a lower risk for problems during pregnancy, during delivery, or both. Talk with your health care provider for specific instructions about staying healthy during your pregnancy.

Nutrition

• At each meal, eat a variety of foods from each of the five food groups. These groups include:
  • Proteins such as lean meats, poultry, fish that is low in fat, beans, eggs, and nuts.
  • Vegetables such as leafy greens, raw and cooked vegetables, and vegetable juice.
  • Fruits that are fresh, frozen, or canned, or 100% fruit juice.
  • Dairy products such as low-fat yogurt, cheese, and milk.
  • Whole grains including rice, cereal, pasta, and bread.
• Talk with your health care provider about how much food in each group is right for you.
• Follow instructions from your health care provider about eating and drinking restrictions during pregnancy.
  • Do not eat raw eggs, raw meat, or raw fish or seafood.
  • Do not eat any fish that contains high amounts of mercury, such as swordfish or mackerel.
• Drink 6–8 or more glasses of water a day. You should drink enough fluid to keep your urine pale yellow.

Managing weight gain

• Ask your health care provider how much weight gain is healthy during pregnancy.
• Stay at a healthy weight. If needed, work with your health care provider to lose weight safely.

Activity

• Exercise regularly, as directed by your health care provider. Ask your health care provider what forms of exercise are safe for you.

General instructions

• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
• Do not drink alcohol, use drugs, or abuse prescription medicine.
• Take over-the-counter and prescription medicines only as told by your health care provider.
• Do not use hot tubs, steam rooms, or saunas.
• Talk with your health care provider about your risk of exposure to harmful environmental conditions. This includes exposure to chemicals, radiation, cleaning products, and cat feces. Follow advice from your health care provider about how to limit your exposure.

Summary

• Women who become pregnant after the age of 35 have a higher risk for complications during pregnancy.
• Problems may affect the mother, the unborn baby (fetus), or both.
• All women should see their health care provider before they try to become pregnant. This is especially important for women over the age of 35.
• Staying healthy during pregnancy can help both you and your baby to have a lower risk for some of the problems that can happen during pregnancy, during delivery, or both.