Nowadays, it is increasingly common to hear about late pregnancies, or what is the same, pregnancies in women over 35 years old.
The labor independence of women and gender equality has led to the search for better opportunities for the professionalization of women, which leads to a possible delay or postponement of the wishes of maternity, being a totally valid fact but in turn it can increase certain risks and disadvantages with respect to pregnant women under 35 years of age.
The first thing to take into account is that, from the embryonic and fetal stage, once the sex is determined, a series of events occur that lead to the generation and formation of a finite number of ovarian follicles, which once once puberty is reached, they will be those who ovulate with each menstrual cycle.
However, as age advances, the quality of these eggs deteriorates, so one of the main obstacles to overcome is the very fact of being able to get pregnant.
Possible risks of late pregnancy
Fertility problems in women over 35 years of age increase exponentially, with very low rates of spontaneous pregnancy at 40 years or older, mainly due to ovarian failure or low reserve.
Despite the fact that age is a very important factor in infertility, it does not only depend on it. As it is considered multifactorial, other factors also intervene in infertility, such as: genetics, personal and family history such as the age of the first menstruation, diseases, pelvic surgery, among other relevant data.
The issue of risks in pregnancies in advanced age is not only summarized in the problems derived from the inability of the ovum to be fertilized, it also refers to the decrease in the implantation rates of the embryo in the uterine cavity and early abortion (in the first 8 weeks of pregnancy) due to chromosomal, immunological or other genetic alterations.
Apart from the risks already mentioned, there are others of equal importance, such as:
1. Increased risk of chromosomal diseases and aneuploidies, such as Down, Patau or Edwards syndrome, as well as structural or functional congenital morphological malformations (such as cardiac, renal, skeletal, neurological, etc., including the association of several anomalies that appear simultaneously).
2. Increased risk of spontaneous abortions, which is to say, pregnancy losses with less than 20 to 22 weeks with no apparent cause. Likewise, a greater risk of pregnancy loss in pregnancies greater than 20 weeks.
3. Increased risk of preterm delivery in older pregnancies compared to younger pregnant women, with fetal complications associated with prematurity, which increase perinatal morbidity and mortality rates.
4. Increased risk of endocrinopathies such as Gestational Diabetes, hypothyroidism and hyperthyroidism, and even hypertensive pathologies such as preeclampsia - eclampsia, gestational hypertension, HELLP syndrome, etc.
5. The late pregnancy may have increased risk of low birth weight or the fetal growth restriction.
6. Postpartum complications, such as postpartum hemorrhages, secondary to uterine hypotonia (decreased uterine contraction), placental accreta (abnormal adherence of the placenta to the myometrium), previous cesarean sections, among others.
As can be seen, the risks are multiple and are part of all stages of pregnancy, whether before conceiving, in the first weeks or at the end of pregnancy and after delivery, however, any increase in risk is always relative and will be more significant as factors are added, such as bad life habits, extremes in age (over 35 years but also under 15 years), personal and family history of risk, multiparity, illiteracy, poor control of pregnancy, unhealthy conditions in the housing sector, overcrowding, among others.
recommendations
Finally, as a general recommendation, although the existence of greater risks and complications in late pregnancies should be taken into account, one should not completely desist from seeking a pregnancy in advanced age if this is done responsibly.
The first thing to do is seek information and medical advice on the advantages and disadvantages of each case. At the same time, communication between the couple is essential and you must be sure of the decision to make.
If you decide to seek a late pregnanc, the preconception consultation is essential to reduce certain risks that can be modified and prevented, with measures such as weight control, treatment of pre-existing diseases, change of bad habits such as smoking or alcoholics, daily exercise, healthy eating, examine and determine alterations that may affect the fertility of both men and women.
Once the pregnancy is achieved, a periodic check-up with your obstetrician should be maintained, so that any alteration that may complicate the pregnancy can be detected, thus bringing a healthy child to a successful term home with his parents.
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