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Advanced maternal age can be described in two ways. It may be defined as the gradual, societal trend upward in age of mothers when they have their first children. Alternately, it may be viewed as the age of the mother when she has her first child. In this case, age 35 or above is medically considered advanced in age.
It is certainly the case that in Western countries, especially, age at which women have their first child has climbed. This is due to a variety of factors. These include greater educational opportunities for women, later age of marriage for many women, and women’s presence in the workforce. While there are still plenty of women who have children while in their twenties and early thirties, a number of women now wait until their mid-thirties or forties to start a family.
From a health perspective, advanced maternal age poses some significant problems. One of these is mentioned with great frequency. It is harder to get pregnant as women get older and they may require various fertility interventions in order to achieve pregnancy. These can be costly and they are not without risk. For instance, in vitro fertilization carries greater risk for heart defects.
There are other known risks of advanced maternal age as pointed out by many agencies that calculate birth defect statistics. One of the highest of these is having a child with Down syndrome. Between the ages of 32 and 35, risk doubles for a child being born with this condition. Ten years later, likelihood of having a child with Down syndrome is ten times higher than at 35.
Miscarriage rate also occurs with greater frequency. Approximately half of all pregnancies end in miscarriage for women in their late 40s. About 20% of pregnancies end this way for women between the ages of 35-40. It is thought that greater tendency to produce children with higher chromosomal abnormalities results in this change.
Other elevated risks include higher chance of having gestational diabetes, stillbirth, premature birth, placental previa, and high blood pressure. Women of advanced maternal age are more likely to require a c-section and/or need to be on bed rest. Some will also be at greater health risk due to development of lifestyle diseases that may first emerge in the late 30s to mid 40s.
Health issues aside, there is another problem with advanced maternal age that I almost never hear anyone mention, but one that worries me with things trending the way they are, and with which I am intimately familiar: the older a woman is when she has a child, the younger that child will be when they lose their mother.
I was born when my mother was in her early 40's. She died when I was 20. Even if she had made it to the respectable age of 70 or 75, I would still have been a young woman when my mother died. My brother, on the other hand -- 17 years my senior -- had almost 40 years with her.
I came as
a surprise, and I don't fault my mother for choosing to bring me into the world, but I know she would not have become pregnant intentionally at that age and I can't help but question the wisdom of those who do it now. They're subjecting their children to a very wide generation gap -- which believe me, can be a big problem -- and depriving them of who knows how many years spent with a young, energetic, healthy parent.
I feel terrible for the babies I've heard of who have been born to women as old as their sixties, at least one of whom died just two or three years later. How many such infants, in addition to lifelong health risks and problems these late births may saddle them with, will never even get to know their moms before they lose them?