Mythbusters in Oncofertility: Geriatric Pregnancy

Now before you start imagining Grandma with a bump, let me explain. Originally the term “geriatric pregnancy” was meant to describe the pregnancy of a woman who was 35 years or older. At some point (probably after being verbally and physically assaulted by hormonal mommies-to-be) the medical community decided to change that term to “advanced maternal age.” Now on to the mythbusting!

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In recent years, women have started childrearing later in their lives due to multiple reasons. From increased birth control and higher career goals to longer life expectancy, women are choosing to have children later. In the ten years prior to 2000, the average age a woman gave birth to her first child increased from 25 to 27 years old. As pregnancies in older women become more common, so do the myths about these pregnancies.

Women have to deal with common misconceptions including infertility. Media reports often suggest that decreased fertility is a severe problem as early as the late 20s. In reality, the risk of sterility is present at low rates even in the early 20s and increases slowly over time. At age 34 only 10% of women are sterile and that increases to 85% by age 44. In contrast to female infertility, it is rarely mentioned that male age also has an effect on infertility. It may be of interest to cougars everywhere that younger men have lower rates of infertility than older ones.

Once a woman over age 35 gets pregnant, she must often deal with assumptions about the health of her pregnancy and child. Maternal or fetal health complications can lead to early labor. Some studies have found that older mothers are at higher risk for preterm labor but these reports are conflicting. Generally, older women are not at increased risk for early labor before 32 weeks (37 weeks is considered normal for delivery). However, very preterm birth (before 28 weeks) is increased in older women. Interestingly, low-birth-weight babies have increased survival rates when they are born to older women-possibly due to better emotional, financial, and medical support.

Another common myth is that mothers with advanced maternal age are at very high risk for birth defects, such as Down syndrome. While this risk does increase over time, only 0.8% of babies born to 40-year-old mothers have Down syndrome. By age 45, this risk increases to 3.5%. It is also important to note that 80% of children with Down syndrome are born to women under age 35, since that is when most women have children.

As usual, the myths tossed around about older women and pregnancy are never as simple as they seem. However, women of any age that have been trying to get pregnant for a year should see a fertility specialist. By age 35, it is suggested that women see a health care practitioner about their fertility if not pregnant after 6 months of trying.