What are the risks of giving birth at an older age? [Doctor-supervised]

Introduction  

In recent years, it is said that pregnant women are getting older due to the trend toward later marriage and the development of assisted reproductive technologies such as infertility treatment.

However, it is said that pregnancy and childbirth at an advanced age pose great risks not only to the pregnant woman but also to the baby. So, what kind of risks are there for pregnancy and childbirth at an advanced age?

In this article, we will introduce the possible risks of pregnancy and childbirth at an older age, as well as the tests that should be taken once pregnancy is confirmed.

From what age is it okay to become pregnant or give birth at an older age?  

In Japan, an older woman is said to be pregnant for the first time when she is 35 years old or older, while worldwide, it includes women who have given birth before becoming pregnant when they are 40 years old or older. If the woman gives birth after that, it is called an older woman’s birth. 

Due to women’s advancement into the workplace and changes in lifestyle, the average age at first birth was 30.7 years old in 2017, which is 5.0 years higher than in 1975 and 4.0 years higher than in 1985.

Although assisted reproductive technology such as infertility treatments have evolved, the optimum age for pregnancy and the time of menopause remain unchanged. For these reasons, it can be said that childbirth and pregnancy at an advanced age pose risks not only to the pregnant woman but also to the baby’s health. 

The optimum age for pregnancy  

A woman’s egg count is highest at 6-7 million when the fetus is still in the mother’s womb at around 20 weeks, decreasing to 2 million when the fetus is around 36 weeks old.

It is said that this number further decreases from puberty (from around 8 to 17 years of age) to 300,000-500,000 during the reproductive age of around 18 to 34 years of age, to 20,000 by around age 37, and to around 1,000 by menopause (around age 51 to 53 years of age).  

A woman’s implantation rate, or her ability to become pregnant, declines slowly until around age 33, but it is said to decline rapidly after age 37, just like the decrease in egg count.  

Furthermore, the quality of eggs declines (abnormalities in the number of chromosomes), with the proportion of women with abnormal numbers of chromosomes increasing from around the age of 35.　　　　　　　　  

On the other hand, this is not just a problem for women, but also for men, testicular function declines with age. As semen volume, normal sperm morphology rate, and sperm motility rate decrease, and the rate of sperm DNA damage increases, it is said that the increase in age in men affects the ability to become pregnant and miscarriage and premature birth.  

It has been reported that compared with men under 25 years old, the probability of becoming pregnant within a year is 50/50 for those over 35 years old.

Unlike women, men do not experience menopause, but as men age, their ability to conceive also decreases.  

The birth rate by maternal age tends to decrease from around the age of 35, and from around the age of 39 onwards the birth rate drops sharply and the miscarriage rate begins to exceed the normal rate.

It has been reported that the risk of miscarriage increases 2.8 times when the mother is over 35 years old, and the risk of miscarriage increases 5.6 times when the couple is over 40 years old.

 

What is likely to happen when giving birth at an older age? 

Pregnancy-induced hypertension  

Pregnancy-induced hypertension is a condition in which high blood pressure occurs between the 20th week of pregnancy and 12 weeks after delivery, and may be accompanied by proteinuria and damage to internal organs throughout the body.

If hypertension occurs before pregnancy or by the 20th week of pregnancy, it is called a pregnancy complicated by hypertension. 

Hypertension is defined as a systolic blood pressure of 140mmHg or higher or a diastolic blood pressure of 90mmHg or higher.  

Pregnancy puts a strain on the body and can cause high blood pressure, so older pregnant women are more susceptible to it than younger women.

In severe cases, there is a risk of the baby’s development being restricted and the mother suffering from cerebral hemorrhage or convulsions, so early birth by Caesarean section is often planned.

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Gestational diabetes  

Diabetes that develops during pregnancy is called gestational diabetes.

Even if you had no abnormalities before pregnancy, your blood sugar level may rise due to changes in hormone secretion after pregnancy. Gestational diabetes is different from regular diabetes, and in most cases it will return to normal after delivery.

However, if you have gestational diabetes, you are at risk of developing pregnancy-induced hypertension, polyhydramnios, difficult labor, large babies, low birth weight babies, and in severe cases, fetal death.  

Pregnancy-induced hypertension and gestational diabetes are said to be more likely to occur in pregnant women who had an obese BMI before pregnancy, who have a family history of hypertension or diabetes, or who experience rapid weight gain after pregnancy.

It is important to consider nutritional balance, pay attention to salt and sugar intake, and get moderate exercise.

Pregnant women over 35 years old, both first-time mothers and those who have given birth before, should be careful about pregnancy-induced hypertension and gestational diabetes. Do not be complacent just because you did not have any problems with your first birth.

What is premature birth, miscarriage, and difficult birth?

Preterm birth refers to the birth of a baby before 37 weeks and 0 days of pregnancy.

A birth between 22 weeks 0 days and 36 weeks 6 days of pregnancy is called a premature birth, and a birth before 22 weeks of pregnancy is called a miscarriage. It is said that miscarriage and premature birth are more likely to occur in older women.

The miscarriage rate is 15% for those aged 30 to 34, 17-18% for those aged 35 to 39, and 25-30% for those over 40. Most miscarriages occur due to factors on the fetus side, such as chromosomal abnormalities.

Older women are more susceptible to miscarriage as the quality of their eggs declines and the ability of sperm to produce a pregnancy also declines with age.  

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Difficult birth  

The birth canal and cervix through which the baby is born gradually become harder as women get older. This often makes it difficult for the baby to pass through, and childbirth can take a long time.

It is said that the incidence of complications such as placenta previa and placental abruption increases with age. In addition, if the mother’s condition becomes critical, an emergency caesarean section may be selected.  

Postpartum problems  

The condition in which the uterus does not contract well after childbirth and does not return to its original size is called uterine involution. It is said that in cases of childbirth at an advanced age, this can cause uterine involution.

Also, if you don’t recover from postpartum fatigue, it can make it difficult to produce breast milk or cause postpartum depression, so it’s important not to push yourself and to use your partner, family, or postpartum care services. Compared to younger pregnant women, they are often more prone to fatigue and have a harder time recovering from it due to their age. It’s important to rest as much as possible without pushing yourself too hard.

Chromosomal abnormalities such as Down syndrome due to advanced pregnancy

Trisomy 21 (Down syndrome) is a chromosomal disorder caused by an extra chromosome 21.

People with this condition have intellectual disability and a variety of physical symptoms.

Children with trisomy 21 (Down syndrome) may have delayed growth, delayed mental development, a distinctive head and facial appearance, and short stature.  

Looking at the probability of a baby being born with trisomy 21 (Down syndrome) by age at birth, the probability is 0.06% at age 20, 0.1% at age 29, and 0.105% at age 30, but increases to 0.34% at age 36 and 0.57% at age 38. In the 40s, the probability increases to 1.22% at age 41, 1.56% at age 42, 2.63% at age 44, and 3.33% at age 45.

There is also data that shows that the rate of births among women over 50 years old, which is considered to be extremely late, is 10%.  

Based on the above, it is possible for a mother to become pregnant with a baby with a chromosomal disorder regardless of her age, but the probability increases with age.

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If you are over 35 and pregnant, Hiro Clinic NIPT

Although pregnancy at an advanced age is a very happy thing, there are still many problems that cannot be overcome even in today’s world of advanced medical technology. And no matter how much we care about our health from a young age, the human body will inevitably age with age, regardless of gender, which can be said to be a law of nature.

The problem with older pregnancy is not just the risks to the mother during childbirth, but also the risk of the baby having chromosomal abnormalities.

Congenital disorders in babies that cannot be detected during prenatal checkups

Many mothers who have become pregnant and given birth at an advanced age say that there were no abnormalities found during their prenatal checkups. General prenatal checkups are important tests to check the health of pregnant women and the development of their babies. However, there are many congenital disorders that cannot be detected by a doctor’s visual inspection, such as an ultrasound scan during a prenatal checkup.

Among congenital diseases in babies, there are those that can be detected and treated early and subsequently develop without problems, and those that are serious and cannot be treated even after birth. At Hiro Clinic NIPT, we will answer all your questions, including these risks, sincerely, believing that it is “the right of mothers and their families to know.”

Types of chromosomal abnormalities in fetuses during advanced pregnancy

Chromosomal abnormalities in fetuses that occur during advanced pregnancy include not only trisomy 21 (Down syndrome) , but also trisomy 18 (Edwards syndrome) and trisomy 13 (Patau syndrome) .

• Trisomy 21 (Down syndrome): delayed growth and mental development, characteristic head and face features, short stature, etc.
• Trisomy 18 ( Edwards syndrome ) : Many pregnancies do not lead to childbirth, and the rate of babies surviving to one year of age is less than 10%.
• Trisomy 13 ( Patau syndrome ): Cleft lip and palate, severe heart disease, etc.

Many clinics use NIPT (non-invasive prenatal testing) to detect the three chromosomal abnormalities listed above. However, at Hiro Clinic NIPT , we also detect other chromosomal abnormalities because we value the right of pregnant women and their families to know.

What is NIPT (New Prenatal Testing) to Know Your Baby’s Chromosomal Information?

NIPT (non-invasive prenatal testing) is a test that checks for chromosomal abnormalities in the fetus using only blood collected from the mother. Previous prenatal tests such as amniocentesis and chorionic villus sampling were performed by using a needle to collect amniotic fluid and cells from chorionic villus tissue from the mother’s abdomen. This meant that there was a risk of miscarriage, as the mother and fetus could be injured during collection.

Amniocentesis, which has a lower risk of miscarriage compared to chorionic villus sampling, can be performed from 15 to 16 weeks of pregnancy. This is because the amount of amniotic fluid is small in the early stages of pregnancy, and collecting amniotic fluid increases the risk of miscarriage during the cycle.

What are non-definitive and definitive tests?

NIPT (non-invasive prenatal testing) is a non-definitive test that checks the probability of positive or negative chromosomal abnormalities. On the other hand, amniocentesis is a definitive test that determines abnormalities in chromosomes. Although NIPT (non-invasive prenatal testing) is a non-definitive test, it is said to have a very high detection rate for trisomy 21 (Down syndrome) , with a sensitivity of 96.5% and a specificity of 99.99%.

Hiro Clinic NIPT only for over 35s (new prenatal diagnosis)

Humans have 22 pairs of 44 autosomes and one pair of two sex chromosomes. One pair comes from the mother and the other from the father, making them diploid.

For these reasons, in order to detect chromosomal abnormalities in your baby other than trisomy 21 (Down syndrome) , trisomy 18 (Edwards syndrome) , and trisomy 13 (Patau syndrome) , it is necessary to examine chromosomes 1 to 22.

NIPT (new type prenatal testing) is a method to detect chromosomal abnormalities in babies in the womb at an early stage . Of course, this is not a test that all older pregnant women must take. However, there are many risks associated with older pregnancy and childbirth.

For these reasons, Hiro Clinic NIPT has prepared an original NIPT (new type prenatal diagnosis) plan, “over35,” for mothers over 35 who are anxious about pregnancy and childbirth at an advanced age .

For information on NIPT (new type prenatal testing) plans , please see ” Hiro Clinic NIPT Prenatal Testing Testing Plans .”

What are the risks of giving birth at an older age? [Doctor-supervised]

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NIPT (New Prenatal Testing) is Ideal for Pregnant Women Who Will Give Birth at an Older Age

In order to have a healthy birth at an advanced age, it is important to have a balanced diet and a stress-free pregnancy. Many media outlets use words that stir up anxiety about pregnancy and childbirth at an advanced age. However, what pregnant women really need are test results and advice from an experienced obstetrician-gynecologist based on a medical perspective.

At Hiro Clinic NIPT , we have performed NIPT (new type prenatal testing) on ​​many pregnant women who will give birth at an advanced age . Our vast data and experience have enabled us to answer the many anxieties of pregnant women with medical values. We will explain in easy-to-understand terms about chromosomal abnormalities in babies, NIPT (new type prenatal testing) , and what to do if the NIPT (new type prenatal testing) is positive.

Hiro Clinic NIPT results available in as little as 2 days

In many cases, samples taken for NIPT (non-invasive prenatal testing) are shipped to testing facilities overseas. Therefore, it takes at least 10 days for the test results to be available. In addition, it cannot be said that there is no risk of human error, such as mixing up samples during transportation.

NIPT (new type prenatal testing) by Hiro Clinic NIPT is performed promptly at the affiliated testing facility “Tokyo Metropolitan Institute of Public Health” in Japan. In addition, at Hiro Clinic NIPT , a barcode is issued when blood is taken for NIPT (new type prenatal testing) , and all blood samples are managed in one place using the testing equipment at the affiliated Tokyo Metropolitan Institute of Public Health, so the possibility of human error such as mixing up samples is extremely low.

Thanks to domestic sample testing and Hiro Clinic NIPT’s unique barcode system, the results of NIPT (new type prenatal diagnosis) tests performed at Hiro Clinic NIPT are usually delivered within 2-5 days after blood sampling (usually within 3-6 days at some clinics and affiliated facilities). In addition, all Hiro Clinic NIPT clinics, excluding affiliated facilities, offer an express delivery option (delivery within 2-3 days after blood sampling). We will safely and reliably inform you of the chromosomal status of your baby, which is the most worrisome thing about advanced pregnancy.

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If the NIPT (new prenatal test) is positive

Let’s say you are pregnant, but are concerned about your age, so you undergo NIPT (new prenatal testing) at Hiro Clinic NIPT . If the test result is positive after the NIPT (new prenatal testing) , you will need to move on to amniocentesis, which is a definitive test, since NIPT (new prenatal testing) is a non-definitive test. However, performing an amniocentesis will incur additional costs.

At Hiro Clinic NIPT, we have set up a mutual aid society for those who have a positive NIPT (new type of prenatal testing) and will be undergoing amniocentesis. By joining the mutual aid society in advance, you can receive assistance for amniocentesis up to a maximum of 200,000 yen (tax included). Of course, the mutual aid society applies to amniocentesis performed at any medical institution. If you would like to know more about the mutual aid society , please feel free to consult with the staff at　Hiro Clinic NIPT .

Precautions for advanced pregnancy  

There are various risks associated with pregnancy and childbirth at an advanced age. However, there are many pregnant women who can give birth safely by undergoing regular prenatal checkups or NIPT (non-invasive prenatal testing) , paying attention to their diet, and taking care of their bodies.

Below we will introduce the nutrients that you should actively take in in order to prepare for pregnancy and childbirth at an older age, as well as how to spend your time appropriately during pregnancy.

Folic acid intake  

Folic acid is one of the most important nutrients during pregnancy.

It is said that women who wish to become pregnant and pregnant women who take folic acid can reduce the risk of their babies developing congenital disorders such as neuroendocrine failure and anencephaly.

The recommended daily intake of folic acid is 240μg for adult women, and 480μg for women who wish to become pregnant and pregnant women. However, it is extremely difficult to obtain 480μg of folic acid from food, so supplements may be used.

Eat a balanced diet and avoid excessive salt intake  

During pregnancy, it is important to maintain a balanced diet. It is important to be careful about weight gain and to consume foods high in protein and iron.

Be careful, as consuming too many calories and salt can lead to preeclampsia and gestational diabetes.

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Exercise moderately  

Light exercise is said to be good for relieving lower back pain and preventing difficult labor.

If your health is stable, doing moderate exercise before pregnancy and building muscle tone can help reduce problems during and after pregnancy. Even if you are confident in your health, it is a good idea to review your lifestyle habits without being overconfident.  

Beware of weight gain  

Rapid weight gain can increase the risk of developing preeclampsia or gestational diabetes, which can result in difficult labor.

Since pregnancy-induced hypertension and gestational diabetes often do not cause any noticeable symptoms, it is important to have regular prenatal checkups at your obstetrician-gynecologist, weigh yourself regularly at home, and make sure to keep your weight under control.  

Summary

Pregnancy at an advanced age not only affects the safety of the mother, but also the baby’s chromosomes. At Hiro Clinic NIPT , we have prepared a number of NIPT (new type prenatal diagnosis) plans that are optimal for older pregnant women who are anxious and at high risk . You may want to consider staying within your budget by efficiently selecting the plan that best suits your age and the chromosomal abnormalities you want to know about. If you would like to know more about pregnancy at an advanced age, childbirth at an advanced age, and the baby’s chromosomes, please feel free to contact Hiro Clinic NIPT .

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