By Dr. Jennifer Landa
With the recent miscarriage suffered by TLC’s “19 Kids and Counting” star, Michelle Duggar, the risks of pregnancy after age 45 have stepped into the limelight. These days, many celebrities are having children at older ages and making it seem easy and the norm, but such a feat is not without significant risks.
The risk of miscarriage in general is high – one in seven pregnancies end in miscarriage, and with the ability to detect pregnancies at very early stages with at-home pregnancy tests, the true union of sperm and egg often ends in a miscarriage 60 to 70 percent of the time. After the age of 40, this risk increases to one in three pregnancies and by age 45 – one in two pregnancies will end in a miscarriage.
A number of factors contribute to this high-risk – the first being lower levels of progesterone. As a woman ages her hormone levels naturally decline. Low progesterone makes the pregnancy at extreme risk for miscarriage because this hormone is responsible for supporting the embryo and growing fetus. Without adequate levels, that support to the fetus is non-existent and the pregnancy fails.
Genetic abnormalities, due to the eggs of an older female being…well, older – also contribute to the riskiness of the pregnancy. In an older egg, the risk of mistakes when the DNA is replicated skyrockets, putting the pregnancy or, ultimately, the baby at-risk. In this case, pregnancies that do make it term have a greater risk of producing a child with special needs. This is something women should take into serious consideration when planning pregnancy after the age of 40.
Not only is pregnancy after age 45 risky for the baby, it can be a challenging situation for the mother-to-be as well. Gestational diabetes and pre-eclampsia are significant disease risks. Both threaten the health and future health of the mother and the fetus. Pre-eclampsia is the number two cause of maternal death in the United States, primarily affecting pregnant women under 20 or over 40 years of age.
In the case of Michelle Duggar, her age was not her only risk factor – women who have had several children are at an even greater risk of premature delivery and postpartum bleeding. After multiple deliveries, the uterus loses its muscle tone. These muscles are essential to slowing and stopping bleeding after delivery – excessive bleeding following delivery can also lead to emergency surgery, hysterectomy or even – death.
Pregnancy is always a blessing and many women might argue that it is worth every risk to bear their own child, however, if you carefully examine the risks – it is not just the health of the mother that is affected – the baby’s entire life could be altered. If you are planning to or do become pregnant at an older age, generally after age 35, talk to your doctor to minimize risks associated with your pregnancy.
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