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Advanced maternal age is a term traditionally used to describe pregnancy when the patient will be 35 or older at the time of delivery. Many women have healthy pregnancies and babies after 35. Pregnancy risks can increase with age, but turning 35 does not suddenly make pregnancy unsafe or mean you will have complications. Age is one of several factors that can influence pregnancy care, and many people have healthy pregnancies and babies after age 35.
Your overall health, medical history, previous pregnancies and how your pregnancy is progressing all help determine what care, screening and monitoring may be appropriate.
Norton Women’s Care provides personalized pregnancy care for people at every stage of pregnancy, including those who may need additional monitoring or specialized expertise because of maternal age or other risk factors.
If needed, Norton Children’s Maternal-Fetal Medicine specialists work alongside your regular OB/GYN to help manage complex pregnancies. Patients can continue to deliver with their regular obstetrician while potentially receiving maternal-fetal medicine (sometimes called MFM) expertise.
Should a baby need specialized care, a patient could be referred to the Norton Children’s Fetal Care Center for additional observation.
The goal is not to treat age itself, but to understand your individual needs and provide the appropriate care for you and your baby.
While advanced maternal age is the medical term used when a person will be 35 or older at the time of delivery, you also may encounter outdated terms such as “geriatric pregnancy” or “elderly primigravida” when researching pregnancy after 35. These terms are older and can sound alarming. Healthcare professionals generally use “advanced maternal age.”
It is important to understand that age 35 is a conventional threshold, not a sudden change in pregnancy risk. Age-related risks generally increase gradually and can become more pronounced as age increases, particularly after age 40.
Being 35 or older does not automatically mean a pregnancy is high risk. Your health, medical conditions, pregnancy history and other factors also help your healthcare provider assess your individual pregnancy risk.
Not always. Your care team will consider your age along with other health and pregnancy factors to determine whether additional care or monitoring would be helpful.
When determining whether additional care or monitoring is appropriate, your healthcare provider may consider:
Some people who are pregnant at 35 or older will receive routine prenatal care from their OB/GYN. Others may benefit from additional monitoring or a consultation with a Norton Children’s Maternal-Fetal Medicine specialist.
Pregnancy after 35 is associated with an increased risk of some complications, including:
The risk of miscarriage also increases with age, in part because chromosomal abnormalities become more common as eggs age.
Remember that these risks do not mean that complications will occur. Prenatal care allows your care team to monitor your health, identify potential concerns and determine whether additional care is appropriate.
Some conditions affecting a baby’s health become more common as maternal age increases. Your care team can explain your individual likelihood of these conditions and discuss appropriate screening and monitoring. Potential concerns include:
The level of risk is not the same for everyone who is 35 or older. Some risks become more significant at older ages, particularly after 40. Your provider can help you understand how your age and other individual factors affect your pregnancy.
Some pregnancy risks become more pronounced as age increases, particularly after age 40.
For people who will be 40 or older at the time of delivery, healthcare providers may consider fetal growth, blood pressure, gestational diabetes, fetal well-being and the timing of delivery.
Your provider may recommend additional ultrasound examinations or fetal monitoring later in pregnancy based on your age and other factors. The American College of Obstetricians and Gynecologists (ACOG) recommends individualized consideration of fetal monitoring and delivery timing if the mother’s age will be 40 or older at delivery.
Many people have healthy pregnancies after 40. Your care team may recommend additional monitoring based on your age, health and how your pregnancy is progressing.
Prenatal testing can provide information about your baby’s health and development. Age alone does not determine which tests you should have.
Your provider may discuss options such as:
ACOG recommends that prenatal genetic screening and diagnostic testing options be discussed and offered to all pregnant patients, regardless of age or risk for chromosomal abnormalities.
It is helpful to understand the difference between screening and diagnostic tests.
Screening tests estimate the likelihood that a baby has certain chromosomal conditions. They do not provide a definitive diagnosis.
Diagnostic tests can determine whether certain genetic or chromosomal conditions are present, but some diagnostic procedures, such as CVS and amniocentesis, are invasive and carry a small risk of complications.
Your healthcare provider can explain the potential benefits and limitations of each option so you can make an informed decision about what is right for you.
Not everyone with an advanced maternal age pregnancy needs additional monitoring. Your care will depend on your age, health and how your pregnancy is progressing.
Depending on your circumstances, your care team may recommend:
Recommendations may differ for someone who will be 35 to 39 compared with someone who will be 40 or older. For example, ACOG’s recommendations include additional consideration of fetal growth assessment and antenatal fetal surveillance (prenatal fetal monitoring) for patients who will be 40 or older.
Your OB/GYN can explain which monitoring is appropriate based on your individual pregnancy.
If you are planning to become pregnant, consider scheduling a visit with your OB/GYN before conception. This gives you an opportunity to review your medical and family history, medications, vaccinations and any health conditions that could affect pregnancy.
Age can affect fertility. ACOG recommends that people older than 35 who have not become pregnant after six months of regular sex without birth control talk with their OB/GYN about an infertility evaluation. For people older than 40, an evaluation may be recommended before trying to become pregnant.
Your OB/GYN can help you understand your options and develop a plan based on your health and pregnancy goals.
Yes. Many people have healthy pregnancies and babies after age 35.
If you are planning to become pregnant, a preconception visit can help you and your healthcare provider identify health conditions, medications or other factors that may affect pregnancy.
Once you are pregnant, early and regular prenatal care gives your care team opportunities to monitor your health and your baby’s development, identify potential concerns and discuss appropriate screening and testing.
Your age is one part of your overall pregnancy risk. Individual health and pregnancy factors matter, too. According to ACOG, early and regular prenatal care can help improve the chances of a healthy pregnancy after 35.
Norton Children’s Maternal-Fetal Medicine specialists are OB/GYN physicians with additional training in caring for pregnancies with complex maternal or fetal needs.
Your OB/GYN may recommend an MFM consultation or ongoing specialist care based on your age, medical history or pregnancy.
Reasons for MFM involvement may include:
Seeing an MFM specialist does not necessarily mean something is wrong with your pregnancy. In many cases, the specialist works alongside your regular OB/GYN to provide additional expertise while you continue receiving routine obstetric care.
Not necessarily. Being 35 or older can increase the likelihood of certain pregnancy complications, but age alone does not mean a pregnancy is high risk. Your overall health, medical history, pregnancy history and other factors also affect your individual risk.
Not necessarily. Prenatal genetic screening and diagnostic testing options should be discussed with all pregnant patients, regardless of age. Screening estimates the likelihood of certain conditions, while diagnostic testing can determine whether some conditions are present. Your healthcare provider can help you understand your options and decide which testing is right for you.
Not necessarily. Some patients 35 and older receive routine care from their OB/GYN, while others may benefit from a maternal-fetal medicine consultation or specialized care. Your age, health, pregnancy history and other pregnancy factors help determine whether a specialist may be appropriate.
Yes. Age alone is not a reason to have a cesarean delivery. If there are no other maternal or fetal reasons for a cesarean birth, a vaginal delivery may be appropriate. Older maternal age by itself does not mean a cesarean birth is necessary.
“Geriatric pregnancy” is an older term sometimes used to describe pregnancy at age 35 or older. The term is outdated and can be misleading, because pregnancy risk does not suddenly change at age 35. Healthcare professionals generally use terms such as advanced maternal age or pregnancy at age 35 or older.