Pregnant over 35 – (no) child’s play?

Pregnant over 35 – (no) child's play?

First a career, then a child: the number of women whose heirs only appear after 30 grows. Does this also increase the health risk for mother and child? Some say it is no longer a problem to have a healthy baby over 35. The risk of giving birth to a disabled child increases with the age of the mother, others say. Both are true. However, the risks of late pregnancy can be avoided mainly if the mother-to-be consistently takes advantage of preventative care options and also checks her blood sugar and blood pressure at home.

The malformation rate is higher.

It cannot be denied that chromosomal disorders increase with the age of the pregnant woman. This means the offspring either gets too much or too little genetic information. The best-known abnormality is Down syndrome (trisomy 21), in which a child has three chromosomes 21 instead of two.

For example, a woman who gives birth at the age of 37 is six times more likely to give birth to a child with Down syndrome than a 25-year-old woman. Doctors are therefore obliged to point out the possibility of so-called prenatal diagnostics to every pregnant woman over the age of 35 or if both parents are 70 years old together.

Methods such as chorionic villus sampling or amniocentesis are currently the only way to unequivocally determine damage to the unborn child, such as haemophilia, Down’s syndrome or an open back. However, this involves risks: the embryo can be damaged by an infection, and the risk of causing a miscarriage as a result of this procedure is 0.5 per cent. The examination of the chromosomes is by no means mandatory. If the pregnant woman were to refuse an abortion even if her child had a malformation or a possible disability, the chromosome test would not be necessary.

 

Well-adjusted to diabetes during pregnancy.

Women who do not have children until after the age of 30 have an increased risk of developing diabetes during pregnancy. Diabetes that first becomes apparent during the forty weeks of pregnancy does so unobtrusively There are no indications. The expectant mother feels well and has no complaints.

Usually, there is only a sugar utilization disorder immediately after meals – experts speak of postprandial hyperglycaemia  – otherwise, usual clinical symptoms such as thirst, increased urination, and weight loss do not occur. Even so, the child is in danger. In addition to an increased rate of miscarriages, women with diabetes give birth to an increased number (2 to 3 per cent) of malformed babies. Women who are over 30 years old, overweight and who have had miscarriages or stillbirths are more likely to be affected.

The problem: The usual examinations using urine test strips reveal only 2 per cent of the actual 6 per cent of women with gestational diabetes. Because the sugar excretion via the kidneys changes, the test shows false positive results, for example. However, the urine sugar can also be within the norm, even though the pregnant woman has diabetes.

Problem gestational diabetes

The oral glucose tolerance test (OGT), recommended between the 24th and 28th week of pregnancy, promises more security. In the USA, it is done with all pregnant women; in Germany, it has not yet been included in the maternity guidelines and is therefore not reimbursed by the statutory health insurance companies. Tip: If you are not privately insured, you should ask your doctor about this test and pay for it yourself. After all, it is an investment in the future!

This is how it’s done:  The pregnant woman drinks a defined glucose solution (sugar solution). Then, the blood sugar is measured. Limit values ​​are fasting: < 90 mg/dl, after one hour: < 165 mg/dl, after two hours: < 145 mg/dl, and after three hours: < 125 mg/dl. If two or more blood sugar levels are abnormally high after drinking glucose, gestational diabetes is diagnosed. If the fasting blood sugar is already high, the pregnant woman usually has to inject insulin until the delivery.

Drugs that non-pregnant diabetics take are taboo for expectant mothers. They would harm the unborn. Blood sugar must be well-regulated and strictly controlled. Why? Excessive blood sugar would fatten the unborn child with sugar—the small human gains immensely in weight and size. The organs are usually more immature than their stage of development would suggest.

Danger! Anyone who has gestational diabetes must expect diabetes to persist after childbirth or come back years later and then permanently. To track down the disease in good time, doing the glucose load test every one to two years makes sense.

 

Measure blood pressure regularly.

A second disease that requires a good attitude is preeclampsia, also popularly known as pregnancy poisoning. About 5 to 7 per cent of pregnant women develop high blood pressure, especially if they are overweight and older. If increased protein excretion in the urine and oedema are added after the 20th week, the symptoms of preeclampsia are complete.

In technical terms, the symptoms are also called EPH gestosis. E, P and H are the first letters of English names for the symptoms: E stands for oedema (oedema, water retention), P for proteinuria (protein excretion) and H for hypertension (high blood pressure). The associated circulatory disorders can cause tissue damage to the organs over time.

The actual cause is unclear. A disturbed interaction between the maternal immune system and the foreign protein of the fetus is discussed as a trigger. Consequence: certain parts of the placenta are not supplied with blood, and the child is not adequately cared for. 20 to 30 per cent of all miscarriages are due to high blood pressure in the mother.

But this is also at risk: the kidneys retain sodium and water and increase water accumulation in the body. As soon as liver activity is impaired, upper abdominal pain, nausea and vomiting become noticeable. Dizziness, headaches and blurred vision can also occur. The mother can get brain spasms (eclampsia), lungs and heart can fail. Cerebral haemorrhage kidney and liver failure are summarized as HELLP syndrome.

A blood pressure of 140/90 mmHg indicates mild preeclampsia, and values ​​above 160/110 mmHg indicate a severe form. In any case, measuring your blood pressure several times a day makes sense. This allows you to intervene quickly if complications should arise.

Nausea: uncomfortable but not fatal

Not always tangible illnesses make Eva’s inheritance a complicated burden. Sometimes, there is only one or the other health inconvenience. For example, more than half of expectant mothers feel wrong about the pregnancy in the first few months—small consolation: Usually, the spook is over after the 14th week at the latest.

Nausea, often associated with vomiting, is an indication of a typically developing pregnancy. The reasons for these ailments have yet to be fully understood. However, there is a connection with HCG (human chorionic gonadotropin), which is produced in the outer lining of the amniotic sac and stimulates the release of progesterone.

From the second trimester of pregnancy, the placenta takes over the tasks of the HCG, which now gradually sinks. This is probably why the nausea subsides after about this time. The question of why not all pregnant women feel nauseous cannot be answered at this time.

Tip: Pregnancy usually affects your stomach in the morning after you get up, so it should help to eat something in bed before you get up. Preparing a small snack in the evening before going to bed is best, be it a rusk or an apple. Eat several small meals throughout the day. If you vomit frequently, drink plenty of fluids. Antiemetics (agents against nausea and vomiting) should only be used under medical supervision if the problem is severe.

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