Risk factor for pregnancies in older women played down

MOST pregnant women aged 35 to 40 give birth to perfectly healthy babies, according to one of the country’s leading experts in foetal abnormalities.

Prof Fergal Malone, head of the department of obstetrics and gynaecology at the Royal College of Surgeons (Ireland), was responding to an editorial in this week’s British Medical Journal (BMJ) called ‘Which career first? - The most secure age for childbearing remains 20-35’.

The editorial said it was harder for older women to become and stay pregnant, and outcomes for the mother and child were poorer. It also said age-related fertility problems increase after 35 and dramatically after 40.

“Women have had more opportunity to acquire pelvic infections or develop endometriosis or premature menopause,” the editorial said.

It also warned against older women depending on IVF treatment to get pregnant: “Paradoxically, the availability of in-vitro fertilisation (IVF) may lull women into infertility while they wait for a suitable partner and concentrate on their careers and achieving security and a comfortable living standard.”

Prof Malone said while the editorial was “a reasonable summary of the state of things”, the majority of women in the 35-40 age group were “absolutely fine” when pregnant and after giving birth.

“Each individual is highly likely to do fine. Sue Bewley (consultant obstetrician and author of the editorial) was looking at the population as a whole and the statistics we have.”

Statistics show the chances of a 30-year-old woman having a Down syndrome child is one in 600 compared to one in 200 for a woman aged 35, but Prof Malone said this was still quite low. Similarly, while older women were twice as likely to develop diabetes or require a C-section, again the overall risk was low, Prof Malone said.

“I wouldn’t get overly alarmed at what it says in the BMJ editorial.

“It is a good article, but remember it does acknowledge for individual women, a short delay poses little absolute risk. Most pregnancies in women older than 35 have good outcomes.

“You can play around with the figures, but overall, for the individual woman, she is still likely to do OK and have a normal baby.”