If you are 35 or over and considering pregnancy for the first time, you are joining an ever-growing group of contented older mothers who are rising to the different challenges that motherhood at that age presents. With advances in prenatal care, as well as the improved nutritional and fitness status of older mothers, pregnancy after 35 is no longer any riskier than pregnancy at an earlier age.
A recent large scale study showed no increased risk for older mothers, just different kinds of risks than for younger mothers. Women over 35 were no more likely to have a premature baby, or to have babies that were small for their age, or to have babies with low APGAR scores at birth (this score measures the vigour of the baby at birth). Women over 35 were also no more likely than younger women to have babies die in the womb, or shortly before birth.
However, the incidence of all chromosomal abnormalities slowly increases with age. The most common abnormality screened for is a cause of mental handicap known as Down's Syndrome. Ninety five percent of Down's Syndrome cases are age-related. At age 30, the incidence of Down's syndrome is about 1 in 1,000; at age 35, it is about 1 in 350 births; and at age 40 the chance of having a Down's child is about 1 in 100.
Dr. Patricia Baird, professor of medical genetics at the University of British Columbia, studied 26,859 children with birth defects. She excluded children with chromosomal abnormalities. She found there was no association between any other type of birth defect and the age of the mother. This also holds true for structural defects, including neural tube defect in which the bone forms incompletely over the spinal chord or brain. Most structural defects can be ruled out by ultrasound. Chromosomal abnormalities can be ruled out through amniocentesis.
Neural tube defects affect 300,000 to 400,000 infants per year worldwide, with 2,500 to 3,000 per year in the United States, and 800 in Canada. Numerous studies have shown that taking folic acid supplements can reduce this incidence by at least 50 percent.
All women of child bearing age should take .4mg folic acid daily or the dietary equivalent starting immediately after they stop using birth control, until at least ten to 12 weeks after a missed period. During pregnancy, women should take at least .8 to 1.0mg of folic acid daily.
Folic acid is present in dark green leafy vegetables, brewer's yeast, whole grains, legumes and organ meats, but it is very sensitive to heat and light and any type of cooking. Since low dose folic acid supplements are very safe, it is wisest to take these supplements on a continuous basis throughout the childbearing years to ensure adequate levels of folic acid.
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