Women who conceive after 35 face complications: Dr Norafidah

Published on: Thursday, May 25, 2023

By: Wu Vui Tek

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The women are also at a higher risk of molar pregnancy due to a higher chance of fertilisation of an abnormal egg, she said in celebrating Mother’s Day which was held on May 14. - Malay Mail pic

Kota Kinabalu: Advancements in artificial reproductive technology have enabled women to conceive late.

But there are certain risks associated with pregnancy at an advanced maternal age, according to Dr Norafidah Ahmad, a Consultant Obstetrician and Gynaecologist at KPJ Sabah.

Women who decide to start a family after pursuing their careers and financial stability, may face higher risks of maternal and perinatal adverse outcomes, she said.

This is particularly for those over the age of 35, she said, while those over 40 and 45 considered to be at very and extremely advanced maternal age, respectively.

The complications include higher risk of ectopic pregnancy, which may be due to the accumulation of risk factors over time, such as multiple sexual partners, pelvic infections, and tubal pathology.

The women are also at a higher risk of molar pregnancy due to a higher chance of fertilisation of an abnormal egg, she said in celebrating Mother’s Day which was held on May 14.

They may also be more likely to conceive multiple pregnancies such as twins or triplets, which increases the risk throughout pregnancy and delivery.

Additionally, she said the prevalence of gestational and pre-gestational diabetes is higher due to a reduction in insulin sensitivity and the deterioration of pancreatic B cell function responsible for insulin production.

This risk can be higher in certain ethnic groups and those who are obese, she said.

Hypertensive disease in pregnancy is also more common in pregnant women with advanced age due to increased endothelial damage as age increases, she said.

Fetal complications associated with advanced maternal age include a higher risk of spontaneous miscarriage, with incidence rates of over 25 per cent for women over 35 years old, followed by 50 and 90 per cent for women over 40 and 45, respectively, she said.

This is mainly due to chromosomal abnormalities in the developing fetus, including Trisomy 21 (Down syndrome), Trisomy 18 (Edward syndrome), and certain congenital abnormalities such as cardiac defects and esophageal atresia, she explains.

Advanced maternal age also increases the risk of premature delivery, before 37 weeks, she said, which can occur spontaneously or as a result of medical termination of pregnancy due to health issues of the mother or fetus.

Besides that, there is a higher risk of having a small for gestational age baby or a growth-restricted baby, due to possible poor oxygen exchange during pregnancy, she said.

Furthermore, she said the risk of fetal death in the womb after 20 weeks is also higher due to placental ageing and vascular dysfunction.

Advanced maternal and paternal age have been found to be risk factors for children with autism, she said.

“Women over 35 who are planning to conceive are recommended to undergo pre-pregnancy counselling,” Dr Norafidah advised.

Dr Norafidah, who has treated patients up to 47 years old, advises caution for women who choose to conceive at an advanced maternal age.

She also recently renovated her clinic with a rainforest theme to bring calmness to anxious patients seeking consultation and treatment.

The recommended age to conceive is 18 to below 35 years old, she said.