In the last few decades, there has been a trend towards deferred child-bearing, especially among healthy, well-educated women with career opportunities.
Earlier, pregnant women aged 35 and older tended to have several unplanned children, whereas today, the proportion of first births to such women is growing. This is due to the reduction in fertility rate and also the time women are taking to conceive.
Major health issues seen commonly among pregnant females, post 40 years, are increased risk of gestational diabetes and hypertension.
This may be due to pre-existing diabetes and hypertension; and also they are more prone to these disorders during pregnancy in this age group. Hence, we should be extra careful in monitoring, detecting and ensuring that there are no further complications.
More so, monitoring of medication along with diet changes is necessary in case of pregnancies post 40 years of age.
For instance, if these women consume too much of carbohydrates, they would become more prone to developing gestational diabetes; and if they had a previous history of high blood pressure, then it is necessary to reduce the salt intake.
Above all, it is advisable to consult a dietitian, so that pregnant women get a tailored diet sheet.
In addition to all the other regular tests for this group of expecting mothers, it is advisable to undergo one extra test called Amniocentesis.
During this procedure, a sample of the fluid that surrounds and protects a baby during pregnancy (amniotic fluid) is withdrawn from the uterus.
This test is typically done after 15th week of pregnancy up to 19th week.
Amniocentesis can identify certain genetic conditions as well as neural tube defects such as serious abnormalities of the brain or spinal cord. Termination of pregnancies due to anomalies cannot be done after 20 weeks, legally.
It is advisable for such pregnancy cases, post 40 years, to ideally deliver in a good multi-specialty hospital.
For such cases, it requires a teamwork of doctors. It is necessary to have other specialists around as well like an Endocrinologist, a Neonatologist and a Physician.
Meanwhile, even after delivery, these women need to be very careful.
They need to be extra careful about the fluid and diet intake, as convulsions after delivery may be expected. However, with proper care and taking regular advices from doctors, pregnancy post 40 years can be managed in a better way.
MD, DGO from Kasturba Medical College (KMC),Mangalore
With over 20 years of experience, Dr. Mangala Ramachandra is currently working as a Consultant, Obstetrician and Gynaecologist at the Fortis Hospitals, Bangalore