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More than 100,000 Americans gave birth in their 40s every year, but what that means to the health of their pregnancy and their babies?

By Reyhan Harmanci

at some point in elementary school, I understand something about my mother: He was older than other mothers. Occasionally, I would write her age on the form or speak about the year he was born, and classmates will be exhaling loudly in response. "Man," he said, "it ANCIENT."

Indeed. My mother is a whopping 29 when she got pregnant, and 30 when she gave birth to me.

This situation came to mind earlier this year, when my father-in-law unprompted expressed concern about the possibility of my husband and I had a second child in "advanced age" I 40. We are going medical disaster, he said, to himself itself and for the baby.

My first response is anger - OK, boomer - but he has a point? In 2019, that while the birth rate for women under 40 has declined over the years, those for women in their early 40s to increase - by 3 percent each year since 1982. The average age of first-time mothers in the United States States are - up from 23 in 1994 and, near where I live, it was 32.

the risk is a slippery concept, and it is difficult to square with the scientific research of one's personal experience, but there are certain undoubtably special danger for what, until recently, called "geriatric pregnancy." To put these issues into perspective, I spoke with six experts to learn about the unique concerns that may arise with having children after 40.

This is probably the most famous part of the equation of aging. The fact is, the eggs gradually decreasing in quantity and quality as you get older. If you are over 35, you are considered of "advanced maternal age" - the most significant fertility starts to decline around 32, according to the American College of Obstetricians and Gynecologists, and took a nose dive very deep. "At age 44, the chances of a spontaneous pregnancy approach zero," said Dr. Jane van Dis, MD, an ob-gyn practice in Burbank, California.

Of course, such reproductive technologies can help some couples skirt around numbers, but even those efforts may be less successful with age. According to the CDC, one in the cycle of in vitro fertilization have a chance of 36 percent successfully impregnate a woman under 35, but has about the opportunity 22 percent for women between 38 and 40, on occasion 13 percent for those 41 or 42, and about a 6 percent chance for women over 42.

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at any age, but is likely to increase as you get older. pregnancy loss that occurs before 20 weeks - called a miscarriage; What then is considered stillborn - almost always caused by a chromosomal problem in the embryo, which is more likely in older eggs. For this reason, according to Dr. van Dis, women between 40 and 44 have a 33 percent chance of miscarriage Throughout pregnancy, the risk of miscarriage is believed to be closer to 10 to 20 percent, although the estimate may vary. It is possible this percentage may be even higher, because, for example, many women who miscarry do so before they know they are pregnant and may not report it.

The evidence also suggests that pregnant women in their 40s are at a higher risk of stillbirth. The reason is a little murky - though in 2008 the researchers suggest that the higher incidence of conditions such as high blood pressure during pregnancy or gestational diabetes among older mothers may be at least partly to blame

For times longer pregnancy. may increase the risk of stillbirth, many doctors will not let a woman over 40 to go to the labor force past her due date. Generally, he will be given a planned induction.

As you age, your chances of developing cardiovascular problems such as high blood pressure and increased heart disease. This is one reason women over 40 are at higher risk for (high blood pressure and protein in the urine during pregnancy, which can be life-threatening) (abnormally high blood sugar during pregnancy) and. These conditions may cause a number of problems for mother and baby -. including low (or abnormally high) birth weight and preterm delivery

Another major problem is the increased chance of developing placental previa, a condition in which the placenta partly or completely covers the cervix. Throughout pregnancy, will develop the condition, with evidence suggesting a higher risk for women 35 years or older. Placenta previa is dangerous, and can increase the risk of premature labor and stillbirth

This is probably the biggest surprise for me. Research shows that the older a new mother is when she has her first child, she took a high risk for breast cancer. According to Louise Brinton, formerly head Ph.D.who Hormonal and Reproductive Epidemiology Branch at the National Cancer Institute, women who have their first child after 40 may be at slightly higher risk of developing breast cancer in the next decade or more labor than those who give birth before they were 20. "simplistic view is that your age, your cells are constantly changing, and a heavy dose of hormones can promote them into cancer," said Dr. Brinton.

How can this phenomenon be translated into an absolute, rather than relative, risk, however, is a little thorny. A, for example, found that among women who have children between 34 and 47, 2.2 percent of developing breast cancer within three to seven years after they gave birth (among women who never had children, the rate was 1.9 percent ). Over all, according to the American Cancer Society, women between 40 and 49 have a 1.5 percent chance of developing breast cancer.

To confuse things further, the study also showed that a history of childbirth may have a protective effect against breast cancer later in life, said Hazel Nichols, Ph.D., a professor of epidemiology at the University of North Carolina Gillings School of global public Health and one of the authors of the study in 2018. Thus slightly increased risk of breast cancer after giving birth later in life can be balanced by having more children in general.

The best thing you can do, Dr. Brinton says, is to make sure that your doctor aware of this risk and that you regularly screened with a mammogram.

Once again, the older the egg, the more likely it is to have a chromosomal problem, which can increase your child's risk for certain birth defects. For women who are pregnant at 25, the risk of Down's syndrome, the most common chromosomal condition, about one in 100.

Of course, for chromosomal problems such as Down syndrome allows you to obtain genetic information about your child as early as 10 weeks ,

There are also some, if limited, evidence that older fathers may pose a particular risk to their children. A, for example, found that babies born to fathers 45 or older are at higher risk for certain complications such as low birth weight, low Apgar scores (a quick test to measure the baby is the welfare of one and five minutes after birth) and premature birth. They also were more likely to develop autism, schizophrenia and obsessive-compulsive disorder than the children of men younger. It is important to note, however, that all such observational studies, so further research is needed.

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What, then, to make of all this? The most optimistic doctor I spoke with Dr. James Grifo, M.D., Ph.D., director of the program at NYU Langone Fertility Center. He pointed out that while "Pregnancy is one of the riskiest countries that experience most women in their lives," the possibility of catastrophic events is still low. "The average age of my patients was 39, and with the content, they do quite well," he said. "Age is not an excuse to not try if you want a baby."

Over and over, I found myself having two conversations with the experts: Wrong about what they know of their patients or their research, and the other about their choices made about when to have children of their own.

Dr. Brinton, for example, who had a daughter when she was 42, said that he was the biggest problem is the "social" rather than medical. "I have always been older mothers," he said. "When I would go to school, I would ask if I was her grandmother. When it comes from a child, was stabbed in the heart. "

Dr. van Dis, who gave birth to twins at 39, said she wished she had a child when she was younger, but not because of health risks. He previously postpone having children because of his medical career and then her husband's ambivalence to start a family - and now he's divorced. "I would tell my younger self that is better to be single mothers than partner with someone who is not committed to you, simply because you think you will not be able to have a family if you do not have a partner, "he said.

Is it responsible or smart to try to have children at 40? studies psychology tells us that people have difficulty imagining themselves as a subject, which is probably why we persist in rolling the dice. Joan Didion tells us that "" What my father-in-law did not know was that when he sent a note, I've been pregnant.

Reyhan Harmanci is deputy head of programming at the drill.

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