What is pregnancy at an older maternal age, and which problems may become likelier? How monitoring is planned, screening and diagnostic options, questions.
Pregnancy at an older age describes pregnancies carried at an advanced maternal age. In these pregnancies the likelihood of some problems may increase; but this increase does not mean that the problem will be experienced, and age alone does not determine how your monitoring will be. Your monitoring is planned together with your doctor according to your state of health, your history and your preferences. Screening and diagnostic tests are offered to you as options whatever your age, and you make the decision. Getting pregnant and IVF are outside the scope of this article and are a different area of information.
Is there a single limit for advanced maternal age?
"Advanced maternal age" generally describes being over a certain age; but this limit may vary according to the source and the practice. For this reason giving a single age limit would be misleading.
Does your age determine the outcome of the pregnancy on its own?
According to the current medical view, in a pregnancy at an advanced maternal age, the likelihood of some adverse outcomes may increase even if there is no other health problem. But this is an increase in likelihood, not an inevitable outcome. The state of health, earlier pregnancies and preferences of two people of the same age can be very different from each other.
Which conditions may become more likely at an older age?
In pregnancy at an older age, the likelihood of conditions such as blood sugar and blood pressure problems, some birth and baby outcomes, and a chromosome anomaly in the baby may increase. The details of each condition, how often it is seen and how it will be monitored are assessed separately. An increase in likelihood does not mean that they will be experienced.
How is your monitoring planned in pregnancy at an older age?
Pregnancy at an older age is also monitored within routine antenatal care; the plan is personalised according to your age together with your illnesses, earlier pregnancies and preferences. At the first consultation your history and state of health are assessed, and at later check-ups blood pressure and urine are checked.
Are additional ultrasounds and assessments needed?
In some situations your doctor may request an additional ultrasound or additional assessments that monitor the baby's growth and wellbeing. Your doctor decides whether they are needed, and when and how many times they will be done.
Are screening and diagnostic tests offered only at an older age?
According to the current medical view, in chromosome screening, screening and diagnostic test options should be offered to all pregnant women; if you wish, you may also decline these tests. That is, age does not make one of these tests compulsory on its own.
How can you make the decision about a test?
You determine which test will be recommended, when and according to which result by talking with your doctor. Asking how the tests work and what their limits are makes it easier for you to decide.
How can you support yourself before and during pregnancy?
If the pregnancy has not yet begun, you can ask for a health assessment beforehand for your chronic illnesses and the medicines you use. If you are pregnant, continuing check-ups regularly, following your doctor's advice on medicines and vaccines, and reporting new symptoms without delay are the basic steps. Do not start medicines, supplements or vitamins on your own. If you feel anxiety or a sense of stigma about your age, you can share this with your doctor or a mental health professional.
What questions can you ask when you see your doctor?
- Ask which factors besides your age could affect your pregnancy.
- Find out how your monitoring will differ because of age.
- Discuss which screening and diagnostic tests may be offered to you and the limits of each.
- If you have a chronic illness, ask how your treatment will be continued in pregnancy.
- Ask for it in writing which symptoms mean you should seek care without waiting for the check-up date.
Frequently Asked Questions
Is a separate test done for sugar in pregnancy?
This test is offered to people with a high likelihood of gestational diabetes (diabetes of pregnancy). Whether this test will be done at an older age, and its timing, is decided by your doctor, who assesses your history and your other factors.
The expression "advanced age" upsets me; what does this term mean?
The term is a medical classification and only describes that some likelihoods may be increased. It does not judge a person's worth, the ability to carry a pregnancy or how the pregnancy will turn out. You can tell your doctor that this expression bothers you and, if necessary, ask for mental health support.
If a screening test shows a high probability, is a chromosome anomaly settled?
No. This result is not counted as a diagnosis; a diagnostic test can be done for confirmation, and not having an additional test is also an option. You discuss with your doctor which is suitable for you.
Does advanced age show that the pregnancy will necessarily end with problems?
No. Although some likelihoods increase, this does not mean that these problems will be experienced. Age alone does not determine the outcome.
Is everyone of the same age monitored in the same way?
No. Your state of health, earlier pregnancies and preferences may be different. Monitoring is personalised with this information.
Is a screening or diagnostic test compulsory because of my age?
No. The options are offered regardless of age and you have the right to decline. Age alone does not make a test compulsory.
Are the same additional ultrasounds done in every pregnancy at an older age?
No. Your doctor determines the necessity of additional assessment, its timing and how many times it will be done.
Should I ask about the limits of screening and diagnostic tests?
Yes. Talking about how they work, when they are recommended and what their results mean makes it easier for you to decide.
If I am planning a pregnancy, can I talk beforehand about my chronic illnesses?
Yes. Before pregnancy begins you can ask for a health assessment for your chronic illnesses and the medicines you use.
Should I start vitamins or supplements on my own?
No. Do not start medicines, supplements or vitamins on your own. In pregnancy, follow your doctor's advice on medicines and vaccines.
Should I wait with new symptoms until the next check-up?
No. Reporting new symptoms without delay is one of the basic steps. Find out from your doctor which symptoms mean you should not wait for the check-up date.
Is age-related monitoring based only on chronological age?
No. Besides age, your state of health, pregnancy history and preferences are assessed; the plan is created together with your doctor.
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