With many women opting for careers and stable relationships before starting a family, the average maternal age of first time mothers is on the rise. In fact, according to the CDC, around 9% of new mothers are over 35 years old. While the odds of conceiving drop with age, it’s still very possible to have children past 35.
Advanced maternal age generally refers to women 35 and older. Essentially women over 35 will face more risks and complications, including the following.
- Time to conceive: Because egg quality and quantity decreases with age, it often takes six to 12 months for women of advanced maternal age to get pregnant.
- Multiple pregnancy: Due to hormonal changes for older women, the body is more likely to release multiple eggs, leading to twins.
- Pregnancy conditions: In addition to issues conceiving, pregnancies risks include high blood pressure and gestational diabetes. Both conditions can lead to complications during pregnancy and during delivery, if left untreated.
- Chromosome abnormalities: Women over 35 will have a higher risk of chromosome issues such as Down syndrome.
- Pregnancy loss: The risks of miscarriages and stillbirths also increase for mothers with age. All of the above issues (egg quality, chromosome abnormalities, high blood pressure, and diabetes) can increase the risk of miscarriage.
While all of these risks are real and possible, many women have safe and healthy pregnancies after 35. The first step is always going to be diet and exercise. Get your diet in check with a focus on fruits, vegetables, lean protein, and whole grains. Aim to eat clean as much as possible, which refers to eating actual ingredients rather than pre-made foods. Find some quick and easy recipes that use real ingredients.
Exercise is also so important. Get moving! Almost anyone can take a 30-minute walk per day. It’s easy and available to most people’s current health condition. Walking is the most basic way to get moving, as it eliminates any excuse to skip exercising that day. Other ways to get in shape include swimming, aerobics, yoga, cycling, and circuit training. If you are new to working out, start by walking and work up from there.
It’s also imperative to severely limit or avoid alcohol and tobacco when preparing to conceive. While caffeine is okay, limiting the amount of caffeine is also a wise move.
In addition to diet and exercise, make an appointment to talk with your OBGYN to assess your own plan. Your doctor will discuss options for fertility testing, if and when it’s needed. Your doctor can also discuss DNA screening and testing for chromosomal abnormalities.
The real takeaway is that the best way to prepare for conceiving over 35 is to get healthy through diet and exercise in order to prepare your body.
More
Many women report changes in their memory during pregnancy. Though memory loss is not reported as a usual symptom that comes about with pregnancy, empirical evidence shows that absent-mindedness among pregnant women is more common than in non-pregnant women.
Also known as “baby brain,” it refers to the changes that occur in cognitive and executive functioning, as well as in memory, due to the increased levels of sex hormones. Some explanations of memory loss attribute it to the elevated anxiety pregnant women experience, seeing as they are preoccupied with a major life change and the responsibility of a new life. Other research points to changes in the brain that prepare women for motherhood.
More specific findings suggest pregnant women experience altered spatial perception and memory, as the heightened hormones may negatively affect the neurons in the hippocampus—the part of the brain responsible for spatial memory.
What to expect?
Undoubtedly, the stress that comes with preparing for the arrival of a baby (or more than one!) is bound to contribute to absent-mindedness and some slight disorientation, especially as far as new surroundings or new information are concerned.
Stress before giving birth is to be expected, as is a decline in good mood. Some women even experience signs of depression during pregnancy, as well as shortly after. In addition to stress and a generally sad mood, these might include:
- Declined interest in fun activities
- Changes in sleep pattern, energy and appetite
- Finding it challenging to concentrate and make decisions
- Feelings of worthlessness or shame
- Questioning life’s worth
How to manage it
Though it is yet unclear whether mild depression or increased hormone levels are causing memory loss in pregnant women, it does seem to dissipate shortly after the baby has been born.
It is advised that if these symptoms persist for a long time after birth, or if you have had a history of depression, you consult your health professional.
Despite the increased anxiety that comes with caring for a newborn, expectant mothers should try to ease their mind and keep their focus sharp to the best of their abilities by engaging in activities that help them feel less stressed.
More
Pregnant women have unique health needs, as the foods they eat are the main source of nutrients for a growing baby. To cultivate healthy eating during pregnancy, it is important for pregnant women to plan in terms of vitamins and minerals and include foods that meet their unique nutritional needs, while limiting or avoiding certain processed foods, meats, and cheeses.
Foods to avoid:
For starters, pregnant women should avoid: refrigerated meat spreads; unpasteurized juices or milk; store-made salads (chicken, egg, tuna); unpasteurized soft cheeses (brie, feta, blue); raw sprouts; raw fish or refrigerated uncooked seafood (sushi, nova-style, lox, kippered, smoked, jerky); processed meats (hot dogs, deli meats); and certain cooked fish (shark, swordfish, king mackerel).
While fish and shellfish provide many important nutrients, such as iron and omega-3 fatty acids, pregnant women should be careful about both the type and frequency of seafood ingestion. The U.S. Department of Health and Human Services Office of Women’s Health recommends the following guidelines:
- Avoid fish high in mercury, such as swordfish, tilefish, king mackerel, and shark
- Eat up to six ounces per week of canned albacore or chunk white tuna
- Eat up to 12 ounces per week of cooked fish and shellfish including shrimp, crab, clams, oysters, scallops, canned light tuna, salmon, pollock, catfish, cod, and tilapia
Healthy foods to eat:
During pregnancy, women need increased levels of folic acid, iron, calcium, vitamin A, vitamin D, and vitamin B12. Specifically, pregnant women need 400 to 800 micrograms (mcg) of folic acid, 27 mg of iron, 1,000 mg of calcium, 770 mcg of vitamin A, 600 international unit (IU) and 2.6 mcg of vitamin B12. While taking supplements may help to reach these nutrient levels, it is preferable to consume vitamins and minerals through foods as certain supplements can contain higher than recommended levels of nutrients, which can be harmful to pregnant women.
To achieve healthy eating during pregnancy, see the list below of suggested foods per nutrient type especially important for pregnant women. This is not an exhaustive list but rather a starting point to help women plan a healthy diet for themselves and their babies.
Folic Acid/Folate
- Whole grains
- Avocados
- Eggs
- Beets
- Asparagus
- Leafy greens
- Legumes (lentils, peas, beans, chickpeas, soybeans, peanuts)
- Citrus fruits
- Brussels sprouts
- Broccoli
- Nuts and seeds
- Bananas
Iron
- Seafood (see specific seafood guidelines for pregnancy above)
- Legumes
- Broccoli
- Dark, leafy greens
- Lean meat
- Quinoa
- Nuts and seeds
- Tofu
- Dark chocolate
Calcium
- Dairy products
- Broccoli
- Dark, leafy greens
- Collard greens
- Soy beans
- Bok choy
- Oranges
- Seafood
- Legumes
Vitamin A
- Sweet potatoes
- Broccoli
- Dark, leafy greens
- Carrots
- Black-eyed peas
- Red bell pepper
- Mango
- Melon
- Apricots
- Tomatoes
- Pumpkin seeds
- Berries
Vitamin D
- Dairy products
- Fish liver oil
- Salmon
- Tuna
*Note: Vitamin D is the hardest nutrient to get solely from foods. A vitamin D supplement is recommended.
Vitamin B12
- Beef
- Chicken
- Seafood
- Dairy products
- Fortified breakfast cereal
- Eggs
More
Gestational diabetes is a form of the metabolic disease that impacts pregnant women who do not have a previous history of diabetes, but who have high blood glucose levels during their pregnancy. The Centers for Disease Control and Prevention (CDC) estimate that in 2014 as many as 9.2 percent of pregnant women suffered from this condition. If you are pregnant or trying to become pregnant, understand the risks and treatment options available to help ensure a safe and healthy pregnancy.
Causes
The causes of gestational diabetes are not completely known, however it is believed that hormones from the placenta that help the infant during development begin to block the action of the mother’s insulin into her own body. When proper insulin levels decline, glucose cannot leave the blood to be converted into energy, instead building up in the blood in unsafe levels, a condition known as hyperglycemia.
Risk Factors
All pregnant women are at risk of developing gestational diabetes, however some women are at a higher risk. Risk factors for gestational diabetes include:
- Age. Women age 25 or older during their pregnancy are more likely to develop gestational diabetes.
- Weight. Women with a body mass index (BMI) of 30 or higher are more likely to develop gestational diabetes.
- Family history. Women who have a close relation, such as a parent or sibling, that has previously been diagnosed with type 2 diabetes are at a greater risk for gestational diabetes.
- Personal health history. Those who have suffered from prediabetes are at a greater risk of gestational diabetes. Prediabetes is a condition defined by slightly elevated blood sugar that may be a precursor to type 2 diabetes. Women are also at a greater risk if they were diagnosed with the condition during a previous pregnancy, if they delivered a stillbirth, or if they delivered a baby who weighed more than nine pounds.
- Race. While experts are uncertain of the reason, women who are African American, Hispanic, American Indian, or Asian are more likely to develop gestational diabetes.
Potential Impact to Mother and Baby
Gestational diabetes impacts the mother in late pregnancy after the baby’s body has been formed. Untreated or poorly controlled gestational diabetes can have serious consequences on infants. Women with gestational diabetes experience an overuse of the pancreas as it works to produce insulin that is ultimately ineffective in lowering blood glucose levels. The high levels of blood glucose are eventually transferred to the baby through the placenta, causing the baby’s pancreas to overproduce insulin as well. Eventually, the extra, unneeded energy is stored by the baby as excess fat, a condition known as macrosomia.
Babies with macrosomia face several potential health risks, including damage to their shoulders during birth, low blood glucose levels at birth due to extra insulin levels, and breathing problems. Later in life, the babies are at a higher risk of suffering from obesity and type 2 diabetes.
Testing
Your OBGYN will likely evaluate your risk factors for gestational diabetes early in your pregnancy. Based on those factors, he or she will help determine a screening frequency to identify any risk factors early. For example, women at high risk may be tested at their very first prenatal visit, while women at average risk will likely be screened during the second trimester.
Women diagnosed with gestational diabetes will require frequent checkups, especially during the final trimester. During these exams, and possibly even in between visits through self-testing, their blood sugar will be monitored. Your OBGYN may also prescribe insulin to help control your blood sugar.
Directly after the birth, your OBGYN will likely check your blood sugar and will want to test it again in six to 12 weeks to determine if levels have returned to normal. Even with an eventual normal reading, women who have been diagnosed with gestational diabetes should receive a diabetes screening at least every three years.
Treatment
In addition to constant monitoring of blood sugar levels, there are treatment options available for women to manage gestational diabetes, including:
- Following a healthy diet high in fruits, vegetables, and whole grains.
- Receiving regular exercise, which helps lower blood sugar by stimulating the body to move glucose into cells and use it as energy.
- The use of insulin, which is prescribed for 10 – 20 percent of women suffering from gestational diabetes.
Every woman strives for a healthy pregnancy. Talk to the doctors at Chouchani, Sayegh and Bagnarello about the factors that may impact your risk for developing gestational diabetes. Our doctors will work with you to help identify any threats early to keep you and your new loved one safe and healthy.
More
