how can increase my chances of having a healthy baby at 35?
May 29, 2013 9:31 AM   Subscribe

I don't plan on having a baby for many years, (I'm 24 now). I have heard that it is bad for the baby's health if the mother gets pregnant at 30 or older.  What risks are there?  How can I mitigate these risks?  What are the odds of having a baby with mental or physical disabilities?  What steps can I take to increase my chances of having a healthy baby at say age 35?  What other relevant things should I Know?  thanks
posted by denimchair to Health & Fitness (27 answers total) 11 users marked this as a favorite
A lot of them are things you should be doing anyway- don't smoke, maintain a healthy weight, exercise regularly, take your prenatal vitamins.
posted by ThePinkSuperhero at 9:35 AM on May 29, 2013 [2 favorites]

This question's been asked around here rather often. The short answer is that it's an urban myth that the risk increases after 30. The long answer is that it depends on your specific risks based on your specific health, and there is no general answer. My fiancee and I plan to have children until she's in her early 40's because she's extremely healthy and has no risk factors. You MUST talk to your primary care doctor and your gynecologist and if possible get details on family history from your parents and grandparents.
posted by SpecialK at 9:36 AM on May 29, 2013 [1 favorite]

A lot of what you believe just isn't true, which says to me that you should do a lot of reading (which everyone should do) on age risks in pregnancy rather than relying on what you've heard.

Risks of some things start to rise faster after 30, true. But between 30 and 35 is still a very low risk age to have children.

I think you should read Taking Charge of your Fertility.
posted by zizzle at 9:36 AM on May 29, 2013 [5 favorites]

Check out the answers to this similar question.
posted by ghost dance beat at 9:37 AM on May 29, 2013

You will make yourself crazy if you balance one risk against another, particularly when you (or the Imaginary Baby's Imaginary Sperm Provider) may have other risk factors that don't become apparent until well into the kid's life.

The risks of having a baby with certain conditions (such as Down Syndrome) do increase with older mothers. However, also consider that older mothers tend to be more stable in their lives: more settled in financial and relationship situations, better access to health insurance and prenatal care, etc.

For an example of this kind of balance: I take a moderately strong antidepressant for a moderate level of depression and anxiety. I'm in Childbearing Prime Time right now, so I have spoken with my OB/GYN and my pdoc about this.
Taking the meds during pregnancy: On one hand, there is some data to suggest that babies whose mothers take certain antidepressants deliver preterm (like, 36+ weeks -- not horrible but not ideal), therefore coming at a lower birth weight and potentially having some issues with attachment, nursing, fussiness, etc. in the first days and weeks. Again: not horrible, but not ideal.
Not taking the meds during pregnancy: I, as the mom, would be C-R-A-Z-Y. My hormones would be zooming all over the place at potentially the most vulnerable time in my life. I could find myself eating or not eating to cope; I could be way more irritable and stressed than normal, all that. A stressed mom is no good for the baby. A baby could be born... preterm, lower birth weight, fussy, yada yada yada.

So you're damned if you do and damned if you don't. This is why internet pregnancy/parenting forums are so INCREDIBLY FUCKED UP. (Present company excluded, of course!)

All you can do (aside from taking that folic acid, amirite?) is be the most healthy, informed and thoughtful person possible -- for yourself, first and foremost. When you're a healthy and stable person, your baby will be way more likely to end up that way, too.

And if your baby doesn't? You'll just be that much more ready to take a deep breath and deal. Shit happens to the best of us, but sometimes that's what MAKES us the best.
posted by Madamina at 9:45 AM on May 29, 2013 [2 favorites]

Mom's Age Risk for trisomy 21 (Down syndrome) Risk for all trisomies
20	                1 in 1,667                  1 in 526
21	                1 in 1,429                  1 in 526
22	                1 in 1,429                  1 in 500
23	                1 in 1,429                  1 in 500
24	                1 in 1,250                  1 in 476
25	                1 in 1,250                  1 in 476
26	                1 in 1,176                  1 in 476
27	                1 in 1,111                  1 in 455
28	                1 in 1,053                  1 in 435
29	                1 in 1,000                  1 in 417
30	                1 in 952                   1 in 384
31	                1 in 909                   1 in 384
32	                1 in 769                   1 in 323
33	                1 in 625                   1 in 286
34	                1 in 500                   1 in 238
35	                1 in 385                   1 in 192

There you go (I think I posted this or something like it in the prior question too). Keep in mind that the majority of babies with Down syndrome are born to younger women despite their risk being lower, because younger women have more babies overall. So - statistics can be misleading to people's decisionmaking processes - when you are the 1 in 1,667, it doesn't help you much that it wasn't likely to be you before it happened. These are not the only risks associated with advanced maternal age (which is what age 35 and older is considered by medical risk categorization), but these are the ones people talk about most commonly.
posted by treehorn+bunny at 9:47 AM on May 29, 2013 [7 favorites]

Another related thread
posted by mbrubeck at 9:53 AM on May 29, 2013

Oh! Also, something that you may not have thought of: keep your teeth and dental/oral health in good shape. You're in a position to do this much more easily now than getting started later, but starting any time is better than starting never.

Oral health is really important for pregnant/nursing mothers. You can get tons of infections that might not seem like a huge deal if you're just bobbing around, living the single life. But if they're left untreated, or if they become chronic issues, they can easily spread to other systems in your body. It's not just a case of "oh, gee, I guess I'll let my toothache go a little longer" -- you can have heart problems because of issues that begin with, say, your gums.
posted by Madamina at 10:10 AM on May 29, 2013

Response by poster: the thing is that i am in China now and i don't have good access to gynecologist.
posted by denimchair at 10:17 AM on May 29, 2013

Honestly, why are you focused on this right now? The short answer is there's no reason to worry, just general good health practices. But there's also no particular reason for you to worry about your current health -- if there is, then deal with that, but linking everything to a theoretical baby (given all the life changes likely between now and a decade from now -- remember highschool?) seems unnecessary and anxiety-producing.
posted by acm at 10:34 AM on May 29, 2013 [7 favorites]

There's some risk in waiting until the age of 35, but the risk is not what you think it is.

My wife has had two children after the age of 35. Our kids turned out fine, although it was considerably stressful waiting for the results of the AFT test with our second child. Getting down to and maintaining a healthy BMI was also something she had to focus on with our second child (BMI can influence fertility, especially for "geriatric pregnancies" after the age of 35).

However, I would say that the greatest risk you face is psychological. After the age of 30, some women really seem to want to have kids. It's that biological clock ticking.

And while women, generally speaking, start to become more interesting in their 30's, if you're still dating, or if you are not in a long-term relationship with someone who wants to have kids after the age of thirty, you may find yourself in a tough spot, unless you want to explore in vitro fertilization etc.

In my experience, the biological clock is very strong indeed.

If you want to wait to have kids, try to find someone now who will wait with you.
posted by KokuRyu at 10:50 AM on May 29, 2013 [2 favorites]

I will add with respect to Down syndrome (and this applies to any child): you don't know what you're going to get. You will be challenged, but you will love and take care of your child no matter what. Honestly, while I need to apply a great deal of thought and attention to my non-typical child, my typical child requires more. DS is not the end of the world and we are a culture where every voice adds the color of the choir.

That said, get in a regimen of regular exercise and ask yourself questions about what you ingest, inhale, or inject (ie, "does this have ingredients that were mined or synthesized?"). Having this as a habit is a good thing anyway for the transition from 20's to 30's. Your metabolism will slow down, but it will affect you less if you're active.
posted by plinth at 11:08 AM on May 29, 2013 [2 favorites]

Just as one data point. I am 11 weeks pregnant with Baby #2 and just had my first ultrasound followed by a pre-natal visit with the actual Dr. today. When she asked if I wanted to do the non-mandatory fetal testing for down syndrome, trisomy, etc. I declined. The Dr. simply nodded her head in the affirmative and said "It's rare for someone your age to have problems there". I'm 33.
posted by ZabeLeeZoo at 12:19 PM on May 29, 2013 [1 favorite]

I agree. In my experience, the healthier the mother is (over the long term), the more likely the baby will be healthy. I suspect that's where the urban legend came from; the effects of living an unhealthy life accumulate over time and the older an unhealthy person is, the less able their body will be to make a baby. Since people were less healthy in the past (overall), the effects seemed more significant.

The statistics about birth defects and lower fertility account for everyone who tries to get pregnant at a certain age. But breaking it down by age alone can be misleading, since many of these problems are problems that can happen at any age, but there are fewer pregnancies among women in the older cohorts to balance things out.

In other words, I don't think an individual's chances of successful pregnancy change as drastically as the statistics might show. If you are going to have a healthy baby at 25 and you stay healthy and strong, you are almost nearly as likely to have a healthy baby at 35.
posted by gjc at 2:10 PM on May 29, 2013

If you're going to wait until you're 35, date guys younger than you so then you can have a baby with a guy who has less potential abnormalities in the sperm he generates.
posted by discopolo at 4:26 PM on May 29, 2013

stop worrying. Best thing you can do!
posted by couchdive at 4:27 PM on May 29, 2013

other words, I don't think an individual's chances of successful pregnancy change as drastically as the statistics might show. If you are going to have a healthy baby at 25 and you stay healthy and strong, you are almost nearly as likely to have a healthy baby at 35.

Yes, but for births over the age of 35, infant health, mortality etc can be affected by the mother (and to some extent the father)'s age. You don't get an AFT test because you're obese or didn't brush your teeth or whatever, you get it because the chances of the child development DS become significantly higher each year after whatever the threshold age is (for the sake of argument, here, say, 35).
posted by KokuRyu at 4:27 PM on May 29, 2013 [1 favorite]

In other words, I don't think an individual's chances of successful pregnancy change as drastically as the statistics might show

treehorn+bunny is a doctor. I honestly wouldn't discount any advice she gives.
posted by discopolo at 4:27 PM on May 29, 2013

The risk of birth defects certainly does increase as maternal age increases, and the idea that this is an urban myth is laughable. But I've never read anything indicating that there is anything one can do to mitigate this -- i.e., it seems largely due to genetics. I suppose the blithe answer to give to women who want to delay giving birth but are concerned about birth defects is to freeze their eggs, but as someone who's been through the sheer, utter hell that is infertility treatment, I'd say that option is not for the faint of heart.
posted by ravioli at 4:32 PM on May 29, 2013 [1 favorite]

My wife gave birth less than a month before she turned 36. Our son is 4 and he is (IMHO) perfect (well, when he's not tired or hungry, anyway).

Be cognizant of the risks. But don't dwell on them. Take care of your own health, get frolic acid supplements, keep a healthy BMI and stay positive.
posted by caution live frogs at 5:54 PM on May 29, 2013

I had my perfectly healthy girl at age 35, and my husband is 4 years older than I am. I had the earliest available prenatal testing because we wanted to be prepared, with no ill effects (cant recall the name of it offhand). I had a very easy pregnancy. Your mileage may vary.
posted by hockeyfan at 7:47 PM on May 29, 2013

I will add with respect to Down syndrome (and this applies to any child): you don't know what you're going to get.

Well, actually you can have testing done that will definitively tell you whether the fetus you're carrying has DS or some other specific abnormalities. When the time comes that you want to get pregnant, educate yourself and discuss with your doctor the risks that come with your age, and the various prenatal tests you can have done.
posted by JenMarie at 9:51 PM on May 29, 2013

Well, actually you can have testing done that will definitively tell you whether the fetus you're carrying has DS or some other specific abnormalities.

I was too vague - my bad. Let me be more specific about what I mean with regards to "you don't know what you're going to get."

Will you know if your child is compliant or strong-willed? Loves to read? Will smash the vase sent to you by your great Aunt Hortense? Will be the world's happiest alarm clock every morning at 5:00? Will be willing to try any food in front of her or reject food because it's green? All these things and more are going to find their way into your lives and are likely to be the dominant things, not the pesky extra chromosome. At the end of the day, a kid with Down syndrome is still a kid.

I never liked that vase.
posted by plinth at 6:33 AM on May 30, 2013 [1 favorite]

I would like to add that there are so many other things that can happen to affect a child --- and some of them -- many of them --- will not be something that could have been prevented anyway.

Having a child is an absolute crapshoot. It just is. You can have a perfectly healthy pregnancy and have a baby with complications or without complications. You can have an incredibly complicated pregnancy and have a child with complications or a child without complications.

And still, there will be other things down the line that you just could not have foreseen. Some things don't crop up until years later. So while you can do what you can do to have as healthy a baby as possible (eat right, exercise, don't smoke, take your vitamins, etc.), there are so many things about having a child and being a parent (as opposed to becoming a parent) that are completely unpredictable while said child is in utero.

The best you can do is the best you can do. No one wants to fall on the wrong side of statistics, but of course it happens. The advice to do what you can and accept that babies and pregnancies are unpredictable under the best of circumstances and you never know what you might get is the best advice you could possibly be given.
posted by zizzle at 7:49 AM on May 30, 2013

Anecdata: I was born to a 36yr old mother and a 40yr old father. Back then, 36 was considered very old, and my mum had to take a lot of tests for Down Syndrome etc. I believe these tests are now required of all pregnant women (unless they opt out) which suggests to me that they don't now believe the risk is any greater for a woman over 30 than under 30.

I was also classed as gifted as a child, but I think this was more about how my mother spent time with me and taught me things rather than any correllation with circumstance.
posted by mippy at 9:24 AM on May 30, 2013

To be clear re: mippy's comment, screening tests for trisomies are now recommended (but not required) for women of any age, not because all women's risks are equal, but because doctors want all women to have access to such screening tests and believe it is reasonable and cost effective to enable that access.
posted by treehorn+bunny at 10:34 PM on May 30, 2013

treehorn+bunny - sorry, should have said I'm in a different country! And yes, the screening is offered on that basis now to help women make informed decisions.
posted by mippy at 3:27 AM on June 4, 2013

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