For women over the age of 35, pregnancy is considered high risk—but what exactly does that mean? Two UC Health OB/GYN experts at West Chester Hospital have the answers.
Lauren Westerfield, MD, is a UC Health OB/GYN at West Chester Hospital and instructor of clinical medicine, University of Cincinnati College of Medicine.
Emily DeFranco, DO, is a UC Health OB/GYN and medical director of Maternal-Fetal Medicine at West Chester Hospital and professor of obstetrics and gynecology, UC College of Medicine.
Why does pregnancy for women over the age of 35 place them at higher risk? How does a mother’s age affect the gestation of her child?
Dr. DeFranco: Most women over the age of 35 are able to anticipate a healthy pregnancy. However, medical conditions such as diabetes, high blood pressure and obesity are more common in older women. Also, women have higher risks of having a baby with a genetic condition, such as Down syndrome, with older age. Those risks increase with every year of maternal age and are not specific to only women over age 35. For example, at age 40 the risk of having a baby with Down syndrome is around 1–2% and increases further with older age. Women over the age of 35 with preexisting medical conditions may experience a higher risk of pregnancy complications, but these risks seem to be more closely related to the mother’s other medical issues rather than just her age.
Why do women’s bodies not allow for childbirth past a certain age?
Dr. Westerfield: Women are born with all the eggs they will ever have. Over time, the number of eggs decreases, and the health of the remaining eggs declines as well. Since women lose eggs over time, this makes it more difficult to become pregnant past a certain point. However, at what age this happens is different for everyone.
Does UC Health offer extra support for high-risk patients?
Dr. DeFranco: Women with high-risk pregnancies may receive special tests during pregnancy such as blood tests, frequent office visits and exams by the high-risk pregnancy subspecialists and even high-complexity studies such as specialized ultrasound and/or MRI. We may also provide invasive diagnostic testing and treatments for some pregnancy conditions including amniocentesis, chorionic villus sampling, fetal blood transfusions and even fetal surgeries. Women with high-risk pregnancies may also receive care by a team of physicians from multiple specialties, which we refer to as multidisciplinary care. This type of care brings together physicians from different medical specialties and is tailored to the type of condition specific to the individual patient. Some examples include having cardiologists, neurologists, anesthesiologists, critical care specialists and pediatric surgeons join in the multidisciplinary prenatal care of high-risk pregnant women.
How can women who become pregnant in their late 30s or early 40s have a healthy pregnancy? What advice can you offer?
Dr. Westerfield: Despite the scary-sounding risks, most patients who become pregnant at this age do have healthy pregnancies. By receiving early prenatal care, women can learn how to watch for signs of miscarriage and can schedule screenings for genetic abnormalities.
Avoid excess weight through regular exercise and a well-balanced diet.
Stay away from smoking, drug use and alcohol.
Check in with your primary care physician and your OB/GYN prior to pregnancy to screen for and control conditions like high blood pressure and diabetes.
How does West Chester Hospital support women who want a healthy pregnancy?
Dr. DeFranco: Our team of subspecialists and obstetricians provides detailed counseling for patients with higher risk pregnancies. We develop a unique pregnancy care plan specifically suited for each woman’s special condition. Our patients can feel reassured through our high-acuity care and close monitoring of both mother and baby.
Dr. Westerfield: At the UC Health Women’s Center, we care for a large number of patients who have children into their late 30s and early 40s. We spend considerable time with all patients to discuss ways to maximize the health of their pregnancies. We also have support and resources through the UC Health Center for Reproductive Health for those who are having difficulty conceiving and are interested in fertility treatment.
The ABCs of High-Risk Pregnancies
At UC Health, high-risk patients have access to a maternal fetal medicine team renowned for its remarkable expertise, dedication, compassion and extensive educational research. Dr. DeFranco identifies three main types of high-risk pregnancies:
Women who become pregnant and have pre-existing medical conditions, including high blood pressure, heart disease, diabetes, substance abuse disorders, autoimmune disorders, thyroid diseases, genetic (inheritable) diseases, obesity and cancer. We even treat pregnant women who have had transplanted organs before pregnancy, such as liver, kidney and even heart transplants.
Women who develop medical complications during pregnancy. The most common pregnancy complications we treat are preterm labor (labor before 37 weeks) and preeclampsia, which is high blood pressure caused by pregnancy.
Fetal complications. This category includes birth defects and abnormalities of the fetus. Some common birth defects include heart defects, cleft lip or palate, club feet or spinal cord defects. These are conditions that may be identified in the baby by routine ultrasound before delivery.
At West Chester Hospital, our expert team individually and thoroughly assess women with high-risk pregnancies. Family members are encouraged to attend consultations. Care team members deliver diagnoses and treatment plans to every patient with compassion and honesty.
Diagnostic testing and fetal assessment.
Prenatal counseling and support services.
Recommendations for you and your family.
Fetal interventions and fetal surgery.
Postnatal care and long-term follow up.
High-risk pregnancy management.
Genetic and prenatal counseling.
Management of fetal arrhythmias (heart rhythm irregularities).
Intrauterine transfusion (delivering blood to the baby).
Fetal shunt therapy (relieving pressure on the baby’s organs).
To receive the name of an OB/GYN or maternal-fetal medicine specialist at West Chester Hospital, call 513-298-DOCS (3627). Learn more about the Women’s Center by calling 513-475-UC4U (8248).