Risks over age 35?

[Tattiana]

I am 36 and pregnant with my 5th. I am on a mainstream board and it looks as though several docs are recommending routine Amnios for ladies over age 35. I was shocked. I would never do such an invasive procedure just because I am over age 35! When I stated that I would never consent to such a test based on my age and that they should be informed of the risks to one who was wondering about it, another responded that the risks of pregnancy at that age outweighed the risk of the test. HUH? I know many women who had babies at 35, 40 years old who are FINE.

Seriously, is it really that dangerous to be PG after age 35? I did a search for some stats and they freaked me out. If the risk is as high as they say, wouldn't we see more babies with Down's, etc? Or is there something I am missing. I just thought that I would ask here since many moms here are well informed.

Thanks!

[AbbieB]

I'm on baby number 2 while over 35.

I think yes, pregnancy is harder on us "older" moms, but that's life. Our bodies are still completely able to handle pregnancy and birth without interventions.

I think the risks of a genetic problem are very small but just a little bit higher than if you were in your 20's. The big issue for me was would I do anything different if the baby had a genetic problem. The answer was no so no testing for me.

I think you are very wise to not submit to procedures just because you fit into some age bracket. Everybody is a unique person, just like every pregnancy and it would be nice if the medical comunity would treat us that way.

[Grace24]

Amen! I'm 36 and have my first OB appt. Thursday at 8 weeks. I don't know if my age is why they saw me so fast...usually I hear they don't see you til 3 months or something. I am worried about being considered high-risk just cuz of my age. My cousin, a nurse, says I can turn down any test I want though. I'm going to try for as little testing as I can. Good luck to you, I'm in the same boat. Frustrating that I can be so much healthier than a lot of mommas in their 20's but because I'm just over that line, boom, high-risk. Augh!

[mommajb]

The reason amnios are more routine at 35 is that the risk of miscarriage from the amnio is equal to the risk of down's.

There are other ways to test for the age related risks, genetic ultrasound being one.

I am 35 and expecting my 5th. I am not being forced into any testing, it has been offered and left up to me. I haven't had any of the tests done yet and my ob is fine with that. If I test it will be non-invasive and to look for problems severe enough to affect my birth plans (for example, Down's carries extra risk for heart malformations) and perhaps to allow myself to adjust emotionally. At almost 18 weeks I haven't decided yet. I think a caregiver willing to listen and discuss your own situation would be a great help.

[Ruthe]

While the "risks" of having a baby with a defect are higher than the reported miscarriage from amnio rik at 35, it never made sense to me to use that as amnio justification because the risks do not negate each other. An amnio won't prevent defects, although a person could abort if they wanted to. And a miscarriage from an amnio can happen to anyone; not just the parent of a child with a serious life-threatening defect. If you aren't the type to abort, there isn't much value IMO. I think a level 2 ultrasound at 20 weeks is less risky and would pick up many of the types of defects that need immediate attention.

[ASusan]

My OB is very good about letting me decide what tests I/we want. I am 36 and will be 37 at the time of the birth. I have had 2 miscarriages.

I did have a Nuchal fold test at 12 weeks. This is non-invasive: it consists of an ultrasound and collection of 5 drops of blood from the mother (we did this part at home - it was fun!). We learned that my risk for Down's & trisomy disorders was less than that of a 20-year-old. So, no need for further testing.

We did the testing for a number of reasons. One reason is that we may have been willing to abort, because I am high risk due to lupus. So, a pregnancy & birth might be difficult for me. We don't know that my first won't also be my last.

This may be the only testing we do. I may or may not do the 18-20-week ultrasound. My OB said that it was up to me/us. I have a few weeks left to decide.

[Annie37]

I am pregnant w/ #4 at 37. I also gave a HUGE "NO" to amnio.
I think it's horrible the way they try to scare you into getting an amnio. I went to see a genetic specialiast, and man you should have seen/heard her face/voice as she explained the risks of being over 35 ... "But YOU"RE 37 !" Oh I could have smacked her.:irked: I tried to explain to her that I was WELL AWARE of all the risks, that I had done extensive reading on the subject, but she continued in her condescending tone, as if I were a learning-impaired child. I don't know HOW many times I heard the term "downs" thrown around. There is NO history of anything like downs or other genetic stuff in our families, either. I think alot of this stems from the high teen pregnancy rate in this country , we are so used to seeing teeny bopper preggos that an older mom is somewhat a surprise anymore! :lol

[tamagotchi]

If the risk is as high as they say, wouldn't we see more babies with Down's, etc?The likelihood of conceiving a baby with Down syndrome does go up steadily with the mother's age. At your age the likelihood is about 1 in 300. At age 40, about 1 in 100. At my age (my baby is due when I'm 42) the likelihood is about 1 in 60. The likelihood of other chromosomal abnormalities also increases with age.

The reason we don't see so many babies with Down syndrome is because many mothers who get prenatal testing abort their Down syndrome babies. But those numbers are accurate as far as conception is concerned.

If you think you might abort in the case of a chromosomal abnormality, you would want to do the genetic testing. Down syndrome is not the only condition that is tested for in an amnio or CVS test; I personally tested to rule out trisomy 13 and 18 (babies with these conditions usually don't survive more than a few hours).

On the other hand, if you are comfortable with the numbers, and confident you would not abort, the only reason to do testing is if you would change your birth plans if you knew your baby had a disability (some people, for example, might choose a hospital rather than a homebirth in that case). But in that case I think the 20 week ultrasound is a better test than the amnio because you can get more information about what parts of the body may be affected.

[tamagotchi]

Oh, and besides the risk of chromosomal abnormalities... there's no reason to consider someone over 35, or over 40, high risk just because of age. If you're healthy, you're healthy! I had a perfectly normal healthy pregnancy and homebirth last time, and am planning another homebirth this time unless something unforseen comes up. My midwife has had plenty of clients over age 40 in her 20+ years of practice and feels that age is really not a risk factor.

[cupofjojo]

There are higher risks after age 35. They go up at 40. They are also a lot higher if it is your first pregnancy instead of your fifth though.

A family member is an OB and their stance is if the outcome of an amnio is going to change your decision on carrying a baby to term then have one done; if you need to be prepared for the outcome of a disorder then have one. Otherwise no.

There is a high level ultra sound that they can look at the nasal and eye cavities to determine any possible defects. Downs and cleft palate kids have very distinct facial patterns. If the ultrasound shows something questionable then you might decide to go further.

I had one. My first and only pregnancy was nearing 39. I needed that extra assurance and preparation just in case. Also it was nice to know 100% that I was having a boy. Friends would say you won't know until you actually have the baby but the fluid doesn't lie :lol I rested much easier in my pregnancy knowing things were fine.

[k9sarchik]

I am 38 with my first and I'm not doing any testing other then the 20 week U/S.
Both of my grandmothers had babies from age 19 through age 40!
My mother had me at 31 and my sister at 36. And they didn't have to face the onslaught of fear like they do now a days. Nor did they have all the invasive testing.

[mamaliss]

I had a baby at 42 , everything went just fine.

[IfMamaAintHappy]

my wise midwife said that your odds of having a child with a genetic disorder after age 35 are not much higher than they were at 34, 33, 32.... they are higher than when you were 25, you know? Its not like some magic switch gets flipped at 35 that makes things increase dramatically. That helped me feel better. Ill be 35 when this baby is born in October.

[Tattiana]

My doc is on the other side of the spectrum. She hasn't offered anything. I don't think they do Nuchal trans screening or even have level II capabilities here. I am not inclined to do much more than the ultrasound, and I would not abort. I was just curious what other ladies have learned and what they are doing. I am curious, though, how much a regular 20 week ultrasound will tell you as far as Down's since I doubt they have the capabilities of anything more here. I delivered my last baby just before I turned 35, and she is fine, so I have assumed that this one will be fine as well.

[popbaby]

I am 39 and just had my first baby in January. We did no amnio/CSV. They did test my blood for risk of Downs etc, and the results were low for any abnormalities etc.

My DD was born perfectly, 6 hour all natural labour and she is perfect!

[mtn.mama]

I'm so happy to know that I'm in good company. I'm 36 and this is my first baby. I've turned down all testing so far, except an u/s at 7 weeks. I plan to take the baby thats given to me, and deal with it later if there's a problem. Whats meant to be will be, for me.

[twilight girl]

I am 37 and pg with #2. The doc did a nuchal translucency screen via u/s (without the accompanying blood test), and said he saw no need for further genetic testing.

An invasive procedure becoming routine just because of age just doesn't sound right, especially since there are non-invasive methods to rule out the issues that they are looking for with an amnio.

[Sotevenn]

I'm 36 & was referred for the nuchal fold testing (and the ob wanted a scan done anyway b/c of other risk factors). The genetic counselor said part of the "over 35" risk myth is based off old info on miscarriage vs down risk evening out at age 35. We had no desire for amnio no matter what, but she spent a lot of time talking about why NOT to have one & that if someone is interested she doesn't think it's really worthwhile until over 40... I think maybe 42? I know the perinatologist I've seen a few times has brought up that he recommends against amnio screenings for women in my age range...too much risk of miscarriage for something that is still pretty unlikely. It seems a big part of it is that insurance will pay for amnio with no questions asked starting at age 35 (based off some old studies from the 70s/60s).

[hergrace]

I had one. My first and only pregnancy was nearing 39. I needed that extra assurance and preparation just in case. Also it was nice to know 100% that I was having a boy. Friends would say you won't know until you actually have the baby but the fluid doesn't lie :lol

Actually, that's not quite true. Amino results saying "Boy" are 100% accurate. Amnio results saying "Girl" are not 100% because cells from the mother can get into the amniotic fluid and confuse the test.

[Pippi Langstroemp]

Interesting how perceptions of "old" change. My mom's OB suggested she get an amnio with me because she was at the ripe old age of 30. Maybe in 25 years the number 35 will have lost its magic status.

Pippi

[chlobo]

Largely because i was unaware during my first pregnancy I had one. With this pregnancy I had the blood screening done & when it showed my risk to be that of a 22 year old I said no to the amnio.

There are no guarantees when giving birth. They can do all that testing and you could *still* have a baby with a medical problem so I just didn't see the point.

I'm working up the courage to decline the gestational diabetes test because I think it's dumb. If they want to know if I'm diabetic, I'll run a 12 hour curve for them and it will be more realistic. I'd also like to decline the pre-natal rhogam shot. I'm sure I'll get kicked out over that one.

[twilight girl]

I'd also like to decline the pre-natal rhogam shot. I'm sure I'll get kicked out over that one.

I was able to get out of it by bringing in a lab report showing DH's blood type as O- (and swearing that there was absolutely no question that he was the father :lol ).

[Vicitoria]

I would think having your 5th baby over 35 would be no big deal, I mean, you have a pregnancy history to go by.

I had my first at 36 and pregnant with #2 at 39. My OB will only recommend Amnio if you are planning to take action on the results otherwise, there is a risk involved in the test. He does recommend the non-invasive blood test for possibility of Downes. With that he can go to the insurance company with physical evidence for a need for more care during the pregnancy to pay for ultra-sounds etc... I'm also giving birth in a small hospital. If he forsees any problems with the baby like heart problems he will arrange to have me deliver in the city where all the possible medicare would be redily available. Beats having your newborn taken from you and medevacd on a helicopter!

[Shahbazin]

I had my 1st baby at 38, & am having my 2nd at 39 - & will turn 40 2 months after the due date. I have done the 20 wk level II ultrasound each time, to check for heart abnormalities or anything obvious like that, that we could find out ahead of time, but was not at all interested in doing amnio, which seems really invasive - for what result? I guess if you were going to terminate for a defect, it could be useful, but I had a m/c just before my 1st successful preg, & just could not imagine doing anything risky. I hope this rambling makes sense! Anyhow, a risk of 1/100 really says, you're 99% likely to have NO problems - not bad odds.