Pregnancy after 35: Healthy pregnancies, healthy babies

If you're older than 35 and hoping to get pregnant, you're in good company. Many families are delaying pregnancy well into their 30s and beyond — and delivering healthy babies. Taking special care can help give your baby the best start.

Understand the risks

The biological clock is a fact of life. But there's nothing magical about age 35. It's simply an age at which risks become more discussion worthy. For example:

• It might take longer to get pregnant. You're born with a limited number of eggs. As you reach your mid- to late 30s, the eggs decrease in quantity and quality. Also, as you get older, your eggs aren't fertilized as easily as they were when you were younger.

  If you're older than 35 and haven't been able to conceive for six months, consider asking your health care provider for advice.

• A multiple pregnancy is more common. The chance of having twins increases with age. This is because hormonal changes could cause the release of more than one egg at the same time. Also, assisted reproductive technologies — such as in vitro fertilization — can play a role.

• The risk of gestational diabetes increases. This type of diabetes occurs only during pregnancy. It's more common in older age.

  People with gestational diabetes must maintain tight control of blood sugar through diet and physical activity. Sometimes medication is needed too. Left untreated, gestational diabetes can cause a baby to grow larger than average. Having a larger baby increases the risk of injuries during delivery.

  Gestational diabetes also can increase the risk of premature birth, high blood pressure during pregnancy, and complications to your infant after delivery.

• The risk of developing high blood pressure during pregnancy is higher. Research suggests high blood pressure that develops during pregnancy is more common in older age. Your health care provider will carefully monitor your blood pressure, along with your baby's growth and development.

  If you develop high blood pressure during pregnancy, you'll need to see your health care provider more often. Also, you may need to deliver your baby before your due date to avoid complications.

• There's a greater risk of premature birth and having a baby with a low birth weight. Premature babies often have complicated medical problems.
• The chance of having a C-section goes up. After age 35, there's a higher risk of pregnancy-related complications that might lead to a C-section delivery.
• The risk of chromosomal conditions is higher. Babies born to older mothers have a higher risk of certain chromosomal conditions, such as Down syndrome.

• The risk of pregnancy loss is higher. The risk of miscarriage and stillbirth increases with age. This may be because of preexisting medical conditions or because of chromosomal conditions in the baby.

  Research suggests the increased risk of miscarriage may be due to both the decrease in quality of eggs in older age and the higher risk of chronic conditions. Chronic conditions may include high blood pressure or diabetes.

Studies also suggest that men's ages at the time of conception might pose health risks for children.

Make healthy choices

Taking good care of yourself is the best way to take care of your baby. Pay special attention to the basics:

• Make a preconception appointment. Before getting pregnant, talk to your health care provider about your overall health. Discuss lifestyle changes that improve your chances of a healthy pregnancy and baby. Address concerns you might have about fertility or pregnancy. Ask about how to boost the odds of conception. Also ask about options if you have trouble getting pregnant.
• Seek regular prenatal care. When you're pregnant, keep up with prenatal visits. They allow your health care provider to monitor your health and your baby's health. Mention any symptoms that concern you. Talking to your health care provider is likely to put your mind at ease.
• Eat a healthy diet. During pregnancy, you'll need more folic acid, calcium, iron, vitamin D and other essential nutrients. If you're already eating a healthy diet, keep it up. A daily prenatal vitamin can help fill any gaps. Begin taking a prenatal vitamin a few months before getting pregnant.
• Gain weight wisely. Gaining the right amount of weight can support your baby's health. It can make it easier to shed extra pounds after delivery too. Work with your health care provider to put together a plan that's right for you.
• Stay active. Regular physical activity can help ease discomfort during pregnancy, boost energy and improve overall health. It can help increase stamina and muscle strength, which helps with labor and childbirth. Get your health care provider's OK before starting or continuing an exercise program. This is especially important if you have an underlying condition.
• Avoid risky substances. Alcohol, tobacco and illegal drugs are off-limits during pregnancy. Check with your health care provider before taking any medications or supplements.

• Learn about prenatal testing for chromosomal conditions. Ask your provider about prenatal screening and testing. A commonly used screening test is the prenatal cell-free fetal DNA (cffDNA) screening. This is a method to screen for certain chromosomal conditions in a developing baby, such as Down syndrome. During the screening, DNA from the mother and fetus is taken from the mother's blood. It's screened for the increased chance of specific chromosome problems, such as Down syndrome, trisomy 13 and trisomy 18.

  Diagnostic tests such as chorionic villus sampling and amniocentesis can provide information about the risk of specific chromosomal conditions. These tests carry a slight risk of miscarriage. Your health care provider can help you weigh the risks and benefits.

Look toward the future

The choices you make now — even before you become pregnant — can have a lasting effect on your baby. Think of pregnancy as an opportunity to nurture your baby and prepare for the exciting changes ahead.