Pregnancy After 45: A High-Risk Dilemma

As more older women attempt to beat the biological clock and conceive, they are at greater risk for developing birth-related complications. For women over 45, there is less than a 1 percent chance of getting pregnant using their own eggs. Successful pregnancy for women over 45 is nearly always the result of in-vitro fertilization (IVF) and the use of an egg donor.

Researchers at Tel Aviv University reviewed birth records from 2000 to 2008, specifically looking at the records of 177 women who gave birth at the age of 45 and beyond. The majority of the women had IVF and received donor eggs, and 80 percent of the babies were delivered via cesarean section (C-section).

Despite their celebrity, Kelly Presley (age 47), Celine Dion (age 42), and Mariah Carey (age 40), are older pregnant women who are at risk. The premature birth of Celine Dion’s twin sons did not surprise me at all. Women over 35, and especially those over 45 with underlying medical problems, should be treated prior to becoming pregnant. I cannot emphasize this enough.

I will never forget the face of a 45-year-old pregnant hospital worker who expired during birth. She was not my patient, but I would frequently see her delivering mail in the hospital. She unfortunately expired from underlying hypertension (high blood pressure) that was not properly treated, and for some reason her death affected me personally.

The risks of pregnancy-related deaths are sharply elevated for women 45 and older. Women who have heart disease should see their internists or cardiologists for a pre-pregnancy consultation prior to becoming pregnant. The heart system undergoes a tremendous amount of change during pregnancy that includes an increase in the circulating volume of blood both in the body and in the heart, as well as an increase in its heart rate.

Older pregnant women have the highest mortality rate. Older Caucasian women typically die from hemorrhage, an enlarged heart from pregnancy (cardiomyopathy), or a blood clot. Older pregnant African American women usually die from hypertensive disorders of pregnancy, stroke, infection, or other medical conditions.

If you are a pregnant woman who is 45 and older, please seek the medical expertise from a maternal-fetal specialist, preferably one that’s affiliated with a teaching hospital. Your best defense is a good offense. Despite potential complications, with the guiding hands of obstetrical experts, your pregnancy should be fine.

Image credit: PregnantHollywood.com

*This blog post was originally published at Dr. Linda Burke-Galloway*


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