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An increasing number of women today delay
pregnancy well into their 30s and beyond. This age represents an important
landmark as the risk of various complications is higher after this age.
If you are 35 or older, and are either planning or expecting a baby, there
are concerns about which you need to be aware.
Risks After 35 -
As fertility declines with age, lowering
the quality and number of eggs in the ovaries, the biggest hurdle older
women face is conception itself.
Assisted reproductive technology (ART)
such as in-vitro fertilization can help overcome this problem.
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Fraternal twins are conceived more often by older women. Hormonal
changes as well as the use of ART can also result in a multiple pregnancy
among women in this age group. This is associated with higher risk of
complications such as
miscarriage, hypertension,
gestational diabetes,
hemorrhage, anemia and
premature birth. Delivery by cesarean section is
commonly required in cases of twin birth, especially because one or both
fetuses may lie in a breech position.
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The babies of women over 35 are more likely to be
born prematurely, have
low birth weight , and be affected by conditions such as Down’s syndrome
or Edward's syndrome caused by genetic defects and chromosomal
abnormalities. These conditions in turn increase the risks of
miscarriage
and stillbirth.
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The second stage of labor may be unduly prolonged in older mothers as
their uterine muscles don’t work as well as those of younger women.
Inducing labor with drugs like oxytocin is therefore more commonly
required in older mothers. Other interventions like instrumental delivery
and cesarean section may also need to be resorted to in these cases.
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Risk for developing health conditions like
gestational diabetes and
pregnancy-induced hypertension is higher in older women.
Precautions After 35 -
Despite these risks, many women over 35
carry pregnancies to term smoothly. These are some things to mitigate the
risks.
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See your doctor before planning the pregnancy to assess your general
state of wellbeing so that risks are minimized.
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After you conceive, make sure to go for regular antenatal checks, to
ensure that the pregnancy is going well.
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Eat a varied, balanced diet. Take care to get enough of the important
nutrients essential for you and your baby’s development. Deficiency of
folic acid – found in green vegetables, citrus fruits, dried beans and
peas – can put the mother at risk for anemia and lead to low birth weight
and neural tube defects in the baby. Dairy products, leafy green
vegetables and nuts are rich sources of calcium, which help the healthy
development of the baby’s bones. Red meat, fish, poultry, lentils, beans
and spinach are dietary sources of iron, which are essential for
maintaining your immunity and preventing fatigue.
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Remain active and exercise regularly. This keeps you fit and energized,
prevents excessive weight gain and prepares your body for the rigors of
labor. Recent research suggests that exercise during pregnancy benefits
the development of your baby’s
cardiovascular and nervous systems. Consult
your doctor before starting an exercise program to confirm that it is
suitable for you.
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Quit smoking or drinking. Smoking affects the development of the
respiratory system in the fetus and lowers birth weight and immunity.
Alcohol can cause miscarriage or lead to birth defects and learning
difficulties in the child.
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Screening tests (such as ultrasonograms, amniocentesis and chorionic
villus sampling or CVS) can determine the presence of genetic/chromosomal
abnormalities in the fetus. Finding out the risk of possible abnormalities
in their child can help parents be better prepared to deal with the same.
However, some of these, like CVS, are invasive and carry a risk – albeit
small – of
miscarriage.
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It is important to keep sugar levels and blood pressure under control by
following a routine involving disciplined diet, exercising and appropriate
lifestyle changes, to avoid the development of
gestational diabetes and
hypertension.
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Close monitoring is required throughout the pregnancy to prevent
obstetric complications and adverse neonatal outcomes.
Thus, by exercising caution and taking good care of yourself, you can
greatly improve your chances of a healthy pregnancy and an uncomplicated
outcome.
By Dr Rishma Dhillon Pai
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