What Does The Term “Geriatric Pregnancy” Mean

The stroke of midnight as you turn 35 labels you with A.M.A. (Advanced Maternal Age) and introduces you to the term “geriatric pregnancy”. Does this mean your chances of conceiving plummet, and you face heightened pregnancy-related risks? The American College of Obstetricians and Gynecologists (ACOG), amongst others, thinks it might be premature to draw such conclusions.

It’s not as if a switch is flipped. The rules are now different. Individualized risk evaluations are becoming the norm. The correct response cannot be generalized.

What Is a Geriatric Pregnancy?

A “geriatric pregnancy” is commonly understood to be one carried by a woman aged 35 or older. However, modern medical professionals are shifting away from this categorization in favor of personalized care and terms like “advanced maternal age” (A.M.A.).

That’s right; a woman’s chronological age doesn’t tell us much about her health or the health of her unborn child. Even if you are A.M.A., you can still have a healthy baby.

The importance of a person’s genetics, family medical history, and present health condition in conception and pregnancy is becoming more and more of a focus for clinicians. Find out why the phrase “geriatric pregnancy” is being phased out and how modern perspectives on pregnancy after 35 have changed.

Fertilization After Age 35

After age 35, a person’s fertility greatly varies from one another.

The number one factor is really health. A woman’s fertility does not change after age 35, provided her health is otherwise stable.

Nonetheless, as you get older, the number of eggs you have decreases.

“Fecundability,” or the possibility of establishing pregnancy in one menstrual cycle, begins to fall dramatically in the early 30s and then declines more rapidly a few years later at about 37 years.

A major, well-designed study analyzed the likelihood of clinical pregnancy in cisgender women of average fertility after having sex on their most fertile cycle day. It was estimated that 40 percent of women aged 27 to 34 were at risk. It was 30% among cisgender women ages 35 to 39.

The concept of a ticking biological clock has some validity, particularly after age 40.

By the time we reach 45, the ticking might be painfully loud. A woman’s fertility may decrease by as much as 95% between the ages of 40 and 45.

Complications During Pregnancy in the Elderly

The risk of probable pregnancy difficulties rises with age since older persons are more likely to have multiple medical illnesses, such as hypertension and diabetes.

Miscarriage, ectopic pregnancy, hypertension, gestational diabetes, stillbirth, and chromosomal abnormalities like Down syndrome are all more likely with advanced maternal age. At age 35, a woman has a 1 in 204 chance of having a baby with chromosomal abnormalities; at age 37, that risk rises to 1 in 130; at age 39, it reaches 1 in 81; and at age 42, it reaches 1 in 39.

Kathy Leeper, M.D., I.B.C.L.C., medical director of Milkworks, a breastfeeding support clinic in Lincoln, Nebraska, states that age can also impair chest/breastfeeding. She has observed that some older moms have difficulty producing enough breast milk and that this is particularly true of those who require medical assistance to conceive or sustain a pregnancy.

The good news is that people can get more information than ever before about their health and pregnancies thanks to improved health assessment, genetic screening, diagnostic, and counseling choices.

Pregnancy Testing in the Elderly

In the past, a woman’s chance of experiencing a miscarriage after an amniocentesis was about the same as her chance of giving birth to a child with Down syndrome. According to Dr. Dolan, this is where the idea that people over the age of 35 are at an increased risk first emerged. The chance of miscarriage during an amnio is now less than 1 in 500 thanks to ultrasound supervision, making amnio’s “magic age” obsolete.

The ACOG has recently recommended that “all [people] should be offered prenatal diagnosis, regardless of maternal age,” which is what Dr. Dolan states.

Dr. Ross explains that CVS is performed between 11 and 14 weeks, while amniocentesis is performed between 16 and 18 weeks. These two analyses check the baby’s chromosomes and, thus, their genetic soundness.

Pregnancy in Older Women: Recent Developments

Women and Infants Hospital of Rhode Island director of perinatal genetics and maternal-fetal medicine Barbara O’Brien, M.D., notes an increase in successful pregnancies in women over 40. The chances of older adults becoming pregnant and carrying a healthy child have increased as medical science has advanced, thanks in part to advances in infertility therapy. Because of this, fertile mature individuals are more likely to try to conceive.

The age might be a benefit rather than a drawback in certain situations. You’re so much more emotionally ready to be a parent. Patients of advanced maternal age are more likely to treat pregnancy with the reverence it deserves, in my experience.

Is there a conclusion to be drawn? The age of 35 as a cutoff point is an artifact.

Yet not every doctor would agree. Dr. Ross clarifies that “advanced maternal age” means a woman is 35 or older. Those above the age of 40 should be the focus of any potential reclassification efforts. Very Old Mothers Association is what I propose calling them.

One thing is unarguable, regardless of age. Pregnant women who are healthy, take prenatal vitamins with folic acid, manage previous medical conditions, don’t smoke, and are up to date on their vaccines are more likely to conceive and deliver healthy babies.

Financial security and the confidence that comes from knowing that you are deciding to become a parent at your own leisure are two reasons why waiting till beyond age 35 to start a family is a good idea.

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