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"Extreme" Advanced Maternal Age Linked To High Risks In Pregnancy, Birth

Research published in the American Journal of Obstetrics & Gynecology this month shows that “extreme” advanced maternal age (AMA) is associated with increased risks for mother and baby. “Extreme” advanced maternal age is over 45.

I may have sneered at the letters “AMA” scrawled all over my pregnancy file at 35, but at 39, I got it. The fact that it’s harder to get pregnant, stay pregnant and give birth to a healthy baby when you start circling 40 is pretty unavoidable.

An Isreali study looked at 177 pregnancy and birth records from women over 45, and compared them to data obtained from women giving birth at younger ages.

The results showed a significant increase in risk for gestational diabetes, hypertensive complications, preeclampsia toxemia, cesarean section delivery rate, breech presentation, postpartum hemorrhage, blood products transfusion, febrile complications, prolonged hospitalization, and low birth weight for women over 45. The c-section rate was 78.5 percent for the over 45 set compared to 28.9 percent for younger mothers.

“Our findings suggest that this age group is a distinct obstetric high-risk entity; this information may be used for more accurate consultation with women who are contemplating pregnancy in this age group,” wrote the authors.

What I’d like to know is how IVF had an impact on these numbers and whether the increase in multiple pregnancies for older women played a part. When you have twins the likelihood of c-section, low birth weight, premature birth and some of the conditions listed above go up.

Last fall Maude Allen wrote about her experience as an AMA mom and it’s one of my favorite Babble essays. Partly just because it begins, “Even though I know the American dream is bullshit…” but also because she gets to the heart of what it’s like to get pregnant over 40. In her 2007 Babble essay on the same topic, Ondine Galsworth writes,”…you feel like you’re trying to make a three-minute egg with eggs that are already scrambled. When columnists and Sylvia Ann Hewlett, author of Creating A Life, start telling me when I should procreate (or should have procreated), it makes me feel bristly and defensive; unfortunately, a lot of what they say is true.” Essays like these bring more than data to the nuanced reality of advanced maternal age. I recommend them both. Highly.

photo:Fellowship of the Rich/Flickr

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