What Is Considered Advanced Maternal Age?

When it comes to pregnancy, age matters more than many people realize. The term Advanced Maternal Age (AMA) is often used when a woman is 35 years or older at the time of pregnancy. But why 35? And does being over 35 mean you’re automatically at risk for complications? This article will break down what advanced maternal age really means, how it affects pregnancy, and what you can do about it.

What Does “Advanced Maternal Age” Really Mean?

In simple terms, Advanced Maternal Age refers to women who are pregnant at the age of 35 or older. This is the cutoff point in many medical guidelines because it is around this age that fertility begins to decline and certain pregnancy risks increase. But being 35 doesn’t mean you’re old or “high risk”—it just means your body is at a stage where things like egg quality and hormone levels start to change.

Dr. Sarah Wilkins, a maternal-fetal medicine expert, explains: “While age 35 is the traditional cutoff, we know that every woman is different. Some women at 35 are in excellent health, while others may experience challenges earlier.”

Why Does Age Matter When It Comes to Pregnancy?

As women age, several things change that can affect pregnancy:

• Egg Quality and Quantity: Women are born with all the eggs they’ll ever have, and over time, both the number and quality of these eggs decline. By the age of 35, a woman’s ovarian reserve starts to decrease, which means there are fewer healthy eggs available for fertilization.
• Chromosomal Abnormalities: As a woman gets older, the risk of chromosomal abnormalities (like Down syndrome) in her eggs increases. This is due to the natural aging process, which can lead to errors in cell division.
• Fertility: While it’s still possible to get pregnant naturally after 35, it may take longer. Fertility also tends to decline after 35, making it more difficult to conceive. Assisted reproductive technologies (ART) like IVF may become necessary.
• Pregnancy Risks: Certain pregnancy complications are more common in women over 35, such as gestational diabetes, high blood pressure, preeclampsia, and placenta previa. While these risks do increase, it’s important to remember that many women over 35 have healthy pregnancies with proper monitoring and care.

Dr. Rachel Matthews, a fertility specialist, adds: “Yes, there are increased risks, but the majority of women in their late 30s and early 40s have healthy pregnancies. It’s all about early detection and monitoring.”

How Does Advanced Maternal Age Affect Fertility?

One of the first concerns for women considering pregnancy after 35 is the impact on fertility. As mentioned, fertility declines with age. After 35, the chances of conceiving naturally drop, and it may take longer for a woman to get pregnant. This is because the ovaries produce fewer eggs, and the quality of those eggs can also decrease.

For example, a woman under 30 has about a 20% chance of getting pregnant each month. By age 35, that number drops to about 15%. By age 40, it can fall to as low as 5%. However, this doesn’t mean that pregnancy is impossible after 35. Many women conceive naturally, though it may take more time or require medical assistance.

Assisted reproductive technologies (ART) such as IVF (in vitro fertilization) have become more common in helping women over 35 achieve pregnancy. IVF can help by allowing doctors to monitor egg quality, select the best embryos for implantation, and bypass some of the challenges related to age.

Dr. Wilkins emphasizes: “We’re seeing a growing number of women in their late 30s and 40s successfully having babies with the help of ART. It’s not just about age—it’s about personalized care.”

Common Pregnancy Risks After 35

While pregnancy after 35 can be completely healthy, certain risks increase as you get older. Some of these risks include:

1. Gestational Diabetes: This is a form of diabetes that develops during pregnancy and can cause problems like high birth weight and preterm labor. Women over 35 are more likely to develop gestational diabetes.
2. High Blood Pressure and Preeclampsia: Older pregnant women are at a higher risk for high blood pressure and preeclampsia, a condition characterized by high blood pressure and organ damage, which can be dangerous for both the mother and the baby.
3. Miscarriage: The risk of miscarriage increases with age. Women under 35 have a miscarriage rate of about 15%, while women over 40 have a rate of about 35-40%.
4. Chromosomal Abnormalities: The risk of having a baby with a chromosomal disorder such as Down syndrome increases with age. For example, the chance of having a baby with Down syndrome is about 1 in 1,000 for a woman in her 20s, but it rises to 1 in 350 for women at age 35, and 1 in 100 for women at age 40.
5. Preterm Birth: Women over 35 are at higher risk for giving birth prematurely, before 37 weeks of gestation. Preterm birth can lead to complications for the baby, including low birth weight and developmental delays.

However, it’s important to remember that while these risks increase with age, most women over 35 have normal, healthy pregnancies, especially with careful medical monitoring and care.

What Can You Do to Manage Risks?

If you’re over 35 and planning to get pregnant, or if you’re already pregnant, there are several things you can do to manage potential risks:

1. Consult with a Specialist Early: A reproductive endocrinologist or maternal-fetal medicine specialist can help assess your fertility and health and guide you through the best options.
2. Consider Genetic Screening: Non-invasive prenatal testing (NIPT) and other genetic screening options can help identify chromosomal abnormalities early, giving you more time to make informed decisions.
3. Focus on Your Health: Eating a balanced diet, exercising regularly, and managing stress can help improve your chances of a healthy pregnancy. Make sure to stay on top of regular prenatal appointments to monitor any potential complications.
4. Know Your Options: If you’re struggling with fertility, don’t hesitate to explore assisted reproductive technologies like IVF. These methods can help women over 35 achieve pregnancy, even with declining fertility.

Dr. Matthews advises: “The key is proactive care. The earlier you understand the potential risks and take steps to manage them, the better your chances of a healthy pregnancy.”

Conclusion

Advanced maternal age may sound daunting, but it doesn’t mean you can’t have a healthy pregnancy or a healthy baby. With the right care, planning, and understanding of the risks, many women over 35 go on to have successful pregnancies and healthy children. Age is a factor, but it’s just one piece of the puzzle.

If you’re over 35 and planning to get pregnant, or if you’re already pregnant, consult with your healthcare provider to develop a plan that’s right for you. With the right medical support and healthy lifestyle choices, you can achieve your pregnancy goals and give your baby the best possible start in life.

Remember: Every woman’s journey is unique. Don’t let age be the reason you hold back from pursuing your dreams of motherhood