With age female fertility decreases, but we also should keep in mind that with age also appear other problems.
As we all know motherhood is one of the most important durable and intensive interpersonal bond and nowadays more and more women, especially in developed countries, experience motherhood in 40 year of age or even later. The main causes that delay earlier motherhood are career and self-development. That is really often because of financial condition and today women struggle to create balance between their professional and personal life, their passions and interests.
The most common chronic internal diseases in patients older than 45 years:
Other complications with patients above 45 years:
- High risk pregnancy
- Congenital defects and chromosomal abnormalities
- Obstretrical complications
With age female fertility decreases, but we also should keep in mind that with age also appear other problems. Age acts against healthy pregnancy. Late pregnancy because of concomitant general diseases is considered a high risk pregnancy. Mother’s age is recognized as independent stillbirth risk factor even in healthy patient. We know that increased risk of miscarriage or stillbirth in 24th week of gestation or later are related not only to mother’s age, but also to her body weight and her previous obstetrical history and also previous miscarriages. With advanced maternal age also the probability of fetal congenital defects and chromosomal abnormalities increases.
Older women are also in the group of a higher risk of premature delivery. Premature delivery is defined as delivery before 37th weeks of gestation and one of the causes of premature delivery is pharmacological stimulation of ovulation. Additionally, in women who are over 45 years old premature placental abruption is more often. This is related to higher frequency of hypertension and preeclampsia.
Diabetes is one of the side effect of late motherhood. We know that diabetes double the risk of miscarriage. Another possible side effect of late motherhood is hypertension, which is twice more common in women at their 40ties or later - in comparison to the group of young mothers. Another side effect observed in elderly mothers is preeclampsia. This is really a spectrum of symptoms. Among them we find hypertension which is defined as systolic blood pressure over 140 mmHg and diastolic over 90 mmHg with concomitant proteinuria, which means loosing proteins. Preeclampsia means also organ disorders or neurological symptoms, problems with coagulation or with intrauterine growth restriction (IUGR) of the fetus. IUGR is caused by insufficient blood flow through placental vessels, so the fetus is not supplied with oxygen and nutritional compounds and as a consequence the body weight of the fetus is not appropriate. Among preeclampsia we have also organ disorders. This can be renal failure, liver failure or some neurological symptoms and also hematological problems. Especially problems that concern platelets - they are responsible for proper coagulation.
Progressive, age-related changes in endothelium may be related to higher frequency of pregnancy complications in elderly mothers, such as:
- Placenta previa
- Hypertension (chronic hypertension increase the risk of stillbirth thrice)
Thanks to multiple observations, we know that in advanced mother age higher percentage of ceasarian sections is performed and it happens because of previous c-sections, myomas surgery or higher rate of placenta previa in multiparas.
Author: MDPhD Katarzyna Olszak-Wąsik