September 2022

Why Geriatric (Advanced Age) Pregnancy Matters Pregnancies in women over the age of 35 used to be labeled as geriatric pregnancies, now the preferred term is Advanced Age Pregnancy (AAP). While the risks associated with pregnancy increase as a woman ages, there are also many benefits to having a child later in life. AAP pregnancies are becoming more common, and it is important to understand why they matter. What is Geriatric/AAP Pregnancy? Advanced age pregnancies are considered high-risk, due to the increased chance of complications such as gestational diabetes, high blood pressure, and preeclampsia. AAP's between ages 35 to 40 have a 20-30% chance of ending in miscarriage or premature birth. AAP's in women over 40 has an escalating risk. There are a number of reasons why geriatric pregnancies are at a higher risk for complications. First, as women get older, their fertility decreases. This means that the chance of a successful pregnancy decreases as well. Second, as women get older, they are more likely to have health problems such as high blood pressure, diabetes, and heart disease. These health problems can increase the risk of complications during pregnancy. Finally, as women get older, they are more likely to have a premature baby or a baby with a birth defect. This is because older eggs have lower quality. Female Reproductive System How Many Eggs Do I have? At birth you have all the eggs you'll ever have, up to 6 million eggs in early development. That reduces to 1-2 million by the time of birth. At puberty you have 3-400,000 eggs as they reduce by about 10,000 per month before that. Then each month your body chooses 1 egg to release. About 1,000 eggs undergo "atresia", or shrinking into oblivion after puberty each month, so that at menopause you have...less than 100 eggs. By the time you hit 40, you are down to 10% of your egg supply at birth. Research suggests that smoking increases the rate of monthly egg loss. After 40, you have a 5% chance of getting pregnant each menstrual cycle. All pregnant women should see a doctor regularly to monitor their health and the health of their baby. Pregnant women over the age of 35 need to be especially careful to follow their doctor's recommendations to best manage their higher risk. What are the Risks of Geriatric/AAP Pregnancy? While the risks associated with geriatric pregnancies are many and varied, they can generally be divided into two categories: medical risks and obstetric risks. Medical risks are those that are generally associated with all pregnancies, regardless of the age of the mother. These risks include things like gestational diabetes, hypertension, and pre-eclampsia. Obstetric risks, on the other hand, are specific to pregnancies in older women and include things like a higher chance of miscarriage and delivery complications. Overall, geriatric or AAP pregnancies are considered to be high-risk pregnancies. This means that there is a greater chance that something will go wrong during the pregnancy or that the baby will be born with health problems. AAP's are closely monitored by a doctor or midwife. Make no mistake though, advanced age pregnancies are often very successful. What are the Benefits of Geriatric/AAP Pregnancy? There is proof that you might be doing yourself and your baby a favor by putting off childbearing until you're older. Older mothers tend to be better educated and have higher incomes than younger mothers, according to research, meaning they may have more resources available to them. Moms who are older are more likely to live longer. The children of older mothers may be healthier, more well-adjusted, and better educated. How Can We Support Geriatric/AAP Pregnancies? There are many ways in which we can support geriatric pregnancies. First and foremost, we should ensure that these pregnancies are considered high-risk pregnancies and that the mother is monitored closely by a doctor. We can also help by providing information and support to the mother and her family. Additionally, we can ensure that the mother has access to appropriate health care and resources. Making sure any underlying medical problems are well controlled, like hypertension and diabetes, etc. Make sure you start prenatal vitamins with folate several months before planned conception. STOP smoking and using alcohol or drugs. We should also work to destigmatize advanced age pregnancies, and ensure that these pregnancies are treated with the same respect as any other pregnancy.