Oscar-winning actress Geena Davis is pregnant with twins at 48 years old, according to her publicist. While Davis is reportedly doing well, the majority of midlife moms may not have such an easy time, experts tell WebMD.
As women age, the risk of problems in pregnancy increases, including miscarriage, chromosomal abnormalities such as Down syndrome, and other complications such as gestational diabetes, high blood pressure, and bleeding. A study in the February 2000 issue of Obstetrics and Gynecology showed that women over 40 are at higher risk of experiencing the sudden death of their fetuses than their younger counterparts.
Still, for a variety of reasons, growing numbers of women are delaying childbirth. And advances in treating infertility and improvements in prenatal care are making pregnancy safer than ever before for these women.
This is by no means the first star to make news with pregnancy after 40.
"There has been a lot of hype with celebrities like Madonna and [actress] Jane Seymour getting pregnant, and that's great news, but we have to remember that the majority of women trying to get pregnant in their 40s are not going to," says Pamela Madsen, executive director of the American Infertility Association in New York. For these women, fertility drugs or procedures including the use of donor eggs may be options.
"Women's fertility rates drop significantly after age 30, and at 35 they plummet again, and after 40, it starts to get pretty dismal," she tells WebMD. "Our eggs begin aging the minute that we are born, and one thing that doctors can't do is make our eggs young again. Mother Nature is definitely not a feminist, and she wants us to have children in our 20s and 30s."
But "one of the things that we learned from Madonna is that being in good health is more important than age," says Donnica Moore, MD, president of Sapphire Women's Health Group in Neshanic Station, N.J.
Protect Your Pregnancy
Regardless of a woman's age at conception, "the basics are all the same," she tells WebMD. "The most important things are to get proper pre-conception counseling and to begin taking prenatal vitamins containing 400 micrograms of folic acid the second you decide that you want to start trying to get pregnant," she says.
Folic acid, a B vitamin, can help prevent birth defects of the brain and spinal cord when taken before pregnancy and in the early weeks of pregnancy.
Further, "nobody should smoke, especially not pregnant women, and super-duper especially not pregnant women older than age 40," Moore says.
Gregory DeVore, MD, a maternal-fetal medicine specialist at the Fetal Diagnostic Center of Pasadena in California, says medical monitoring is key for pregnant older women.
A genetic amniocentesis at 15 to 18 weeks is important because it can detect spinal cord defects such as spina bifida with 97% accuracy and most chromosomal abnormalities, he tells WebMD.
To perform this test, doctors use a thin needle, inserted through the mother's abdomen, to remove a small amount of the amniotic fluid that surrounds the fetus. The American College of Obstetricians and Gynecologists recommends that all women who will be 35 years or older at the time of delivery should be offered prenatal testing such as amniocentesis.
"Women older than 40 should have ultrasound at 20 to 22 weeks of pregnancy so they can look at the heart and identify any heart defects," DeVore says. "Also at this appointment, we measure arterial blood flow to check for intrauterine growth retardation [of the fetus] or toxemia [pregnancy-induced high blood pressure]."
And at 32 weeks, he says, "We will do an ultrasound to evaluate fetal growth, and if there is a problem, I recommend eight weeks of bed rest.
"If you do these things, I am very optimistic about the outcome," he says.
Published Dec. 3, 2003.
