Advanced maternal age

Advanced maternal age (AMA) is a designation given to women who are thirty-five years and older during delivery or anticipated delivery. Medical professionals believe that, in general, women who are thirty-five and older are more likely than younger women are to develop medical complications during pregnancy. Studies have shown that women of AMA are more likely to have problems conceiving, are more prone to certain health issues during pregnancy, and are more likely to conceive multiples. Although AMA refers to women thirty-five years and older, the risks associated with AMA become more likely over time and vary among different people. Women of AMA can reduce the risk of medical complications during pregnancy by following steps that are suggested for all pregnant women.

Background

AMA is a designation that some medical professionals use to refer to women over the age of thirty-five when discussing pregnancy and fertility. Medical professionals use this designation because studies have shown that women aged thirty-five and older are more likely to develop medical conditions during pregnancy or face difficulties becoming pregnant. Although women are classified as AMA as soon as they turn thirty-five, the possible medical conditions that are related to AMA do not suddenly happen once a woman reaches this age. Instead, the likelihood of these conditions increases slowly over time, and the increase of possible medical complications can differ slightly among women. Medical professionals use the age of thirty-five because, based on research and scientific studies, this is the age when the possible effects of AMA seem to most commonly occur.

Overview

Although the effects of AMA do not turn on like a switch, many women begin noticing some of the possible complications of AMA around the age of thirty-five. Women of AMA are more likely to have problems conceiving. One reason this occurs is that women have fewer eggs available for fertilization each year of their lives. Women are born with all the eggs they will ever have, and they release eggs during ovulation. Older women have fewer eggs than younger women do. Studies have also shown that women over the age of thirty-five are less likely to achieve pregnancy during one menstrual cycle than younger women are. As women age, their chances of conceiving drop even more. Between the ages of forty and forty-five, a woman’s fertility rate can drop as much as 95 percent. The quality of women’s eggs also decreases over time, making the chances of successfully conceiving lower for women of AMA, regardless of the number of eggs they have.

Women of AMA are also more likely to have preterm labor. Preterm labor refers to labor that occurs more than before 37 weeks in pregnancy, when a fetus is not yet fully developed. Preterm labor can cause medical problems, such as lung and vision complications, for infants. Pregnancies in women of AMA are also more likely to end in fetal death—due to miscarriage or stillbirth—and infant death than are the pregnancies of younger women. Women of AMA are also more likely to have babies born with congenital defects and chromosomal abnormalities, such as Down syndrome.

Women who are older than thirty-five are also more likely to experience certain medical conditions when they are pregnant and/or soon after labor. Preeclampsia is a serious health condition that can affect pregnant women and women who recently have given birth. This medical condition causes high blood pressure and other complications. Untreated preeclampsia can lead to maternal death and stillbirth. Gestational diabetes is another health condition that women of AMA are more likely to encounter. Gestational diabetes is a type of diabetes that happens only during pregnancy. This medical condition, like other forms of diabetes, affects how the body uses sugar, or glucose. Women who are diagnosed with gestational diabetes have to control their diets and physical exercise. Untreated gestational diabetes can cause premature birth and high blood pressure.

Although women older than thirty-five may be more likely to have problems conceiving, they are also more likely to conceive multiples (e.g., twins or triplets) when they do conceive. Studies have also shown that women thirty-five and older may face higher chances of caesarean section and women with twin pregnancy have even higher rates of caesarean section and hypertensive disorder. In addition, women of AMA who were pregnant with multiples were less likely to experience fetal death or infant death.

Many studies have confirmed that AMA can contribute to some negative health outcomes, but some studies indicate that these effects become more pronounced at different times. Some studies indicate that these issues affect women who are aged thirty-five and older, but other studies indicate these effects are more likely in women aged forty years and older. Despite the increased possibility of medical complications for women of AMA, some researchers point out that women who choose to have children later in life can receive medical treatment that can help them conceive. These women are also sometimes in better socioeconomic circumstances than younger women are. The number of women giving birth at thirty-five years old or older has increased during the twenty-first century. With advances in medicine and changes in societal norms, women are conceiving far later in life than ever before, into the mid-2020s as the birth rate for women ages between 35 and 39 is 54.3 births per 1,000 and for ages between 40 and 44 12.7. In the 2020s, the birth rate for women ages 25 to 29 have declined while it largely remained unchanged for women aged 35 to 39.

Women of AMA can decrease their chances of experiencing medical complications by taking certain steps that all women can take to increase the likelihood of having a healthy pregnancy. Women of AMA should attend regular prenatal checkups, so their doctors can track their health and their fetuses’ health. These women should also strive to maintain a healthy weight, as having a higher body mass index can make medical complications more likely. They can also reduce the risk of medical complications by avoiding smoking, drinking alcohol, and taking other dangerous substances. Taking prenatal vitamins can also reduce the risk of fetuses developing certain birth defects. Pregnant women, and especially those of AMA, are also encouraged to keep their vaccines up to date. Taking these steps can help ensure that women of all ages will have healthy pregnancies.

Bibliography

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