Advanced Women’s Health Care 1 / Code:( MSNW 113)

Experience of advance age pregnancy

Presented By :
Amnah Ahmed
24000010
Supervised By : Dr.Nadia Eltohamy
 • Definition of Advanced Age Pregnancy
• Discuss the Factors Contributing to Advanced Age
Pregnancy
• Discuss Potential Challenges of Advanced Age
Learning Outcomes Pregnancy
• Explain the potential impact on the mother's
physical and emotional well-being
• Describe the Preparing for Advanced Age
Pregnancy ( important of preconception care )
• Explain the role of healthcare professionals in
providing specialized care during advanced age
pregnancies
 Introduction

Advanced age pregnancy refers to pregnancies that occur in women aged 35 old
and above. In recent years, there has been a notable increase in the number of
women choosing to start families later in life. This may be due to various factors,
such as pursuing career goals, establishing financial stability, or waiting until the
right time. While the decision to have a child at an advanced age is deeply personal,
it is essential to understand the potential challenges, impact, and support available
throughout this journey
 Introduction

This trend's rise has led to extensive conversations among

researchers, medical professionals, and the general public. The
context for an investigation of the complex experience of an
advanced maternal-age pregnancy is established by this background.,
encouraging a group discussion about the effects of postponing
childbearing
 Definition of Advanced The term "advanced maternal age" (AMA) was first
used to describe pregnancies in women 35 years of
Age Pregnancy age and older.
Since the 1950s and possibly earlier, the age
thresholds of 35 and 40 have been used by
researchers to label pregnant people as being
advanced maternal age
In addition to the term AMA, people who are 35 or
older and pregnant for the first time have been
referred to as an elderly primigravida or elderly
primipara. Primigravida means a person who is
“pregnant for the first time.” Primipara means a
person who is “giving birth for the first time.”
Factors Contributing to Advanced Age
Pregnancy

Several factors contribute to the increasing trend of women

choosing to have children at an older age. Some of these
factors include:

• societal factors
• advancements reproductive technology (ART) and fertility
treatments
• Medical issue
societal factors

1st 2nd 3rd 4th 5th Event 6th Event

Delaying
Educational Global Gender Equality
Marriage Financial Changing
and Career Economic and
and Stability Social Norms
Goals Trends Empowerment
Childbearing
advancements reproductive
technology (ART) and fertility
treatments
Medical advancements have played a significant role
in making pregnancy at an older age more feasible
for women.
1. Assisted Reproductive Technologies (ART)
• In Vitro Fertilization (IVF)
• Intracytoplasmic Sperm Injection (ICSI)
2.Egg Freezing (Oocyte Cryopreservation)
3.Fertility Medications and Hormonal
Therapies
Potential Challenges of Advanced
Age Pregnancy While many women in this age group have healthy
pregnancies and deliver healthy babies, there are
certain challenges :

 Decreased Fertility: Fertility declines with age,

and women in their late 30s and 40s may
experience challenges in conceiving. As women
age, the quality and quantity of their eggs
decrease, making it more difficult to become
pregnant .Assisted (IVF) may be necessary to
achieve pregnancy.
Potential Challenges of Advanced
Age Pregnancy
 Higher Risk of Chromosomal Abnormalities:
The risk of chromosomal abnormalities, such as
Down syndrome, increases with maternal age. This
is because the quality of eggs declines as women
get older. Prenatal screening tests, such as
noninvasive prenatal testing (NIPT) and ultrasound,
can provide information about the risk of these
abnormalities.
 Adverse Fetus Outcomes:
Possible adverse fetal outcomes include infants
small for gestational age and intrauterine growth
restrictions, low Apgar score, admission to
neonatal intensive careunits, and an autism
spectrum disorder
Potential Challenges of Advanced
Age Pregnancy
 Increased Risk of Pregnancy Complications:
Advanced maternal age is associated with a higher
risk of certain pregnancy complications. These can
include gestational diabetes, pregnancy-induced
hypertension, preeclampsia, placenta previa,
placental abruption, and cesarean delivery ,
stillbirth , miscarriage .
The risks are primarily due to age-related changes
in the reproductive system and underlying health
conditions that may be more prevalent in older
women.
Potential Challenges of Advanced
Age Pregnancy
 Multiple Gestation: The use of assisted
reproductive technologies, such as IVF, can
increase the chances of multiple pregnancies,
such as twins or triplets. Multiple gestations carry
a higher risk of complications, including preterm
birth, gestational diabetes, and preeclampsia.
 Existing Health Conditions: Older women may
have preexisting health conditions, such as
diabetes, hypertension, or obesity, which can
increase the risks associated with pregnancy. It's
important for women with these conditions to
receive proper medical management and
prenatal care
potential impact on the mother's physical and
emotional well-being
Physical Well-being
• Increased Physical Demands: Pregnancy and childbirth can be physically
demanding for women of any age. However, older women may experience
additional challenges due to age-related changes in physical resilience
and stamina. They may have less energy and endurance to cope with the
physical demands of pregnancy, labor, and caring for a newborn

• Recovery from Pregnancy and Labor: The recovery process after childbirth
can be longer and more challenging for older women. It may take more
time for their bodies to heal, and they may experience more discomfort
and fatigue during the postpartum period
potential impact on the mother's physical and
emotional well-being

Emotional Well-being

• Increased Anxiety and Stress: Advanced age pregnancy can bring added anxiety
and stress for the mother. There may be concerns about the increased risk of
complications, chromosomal abnormalities, and the overall well-being of both the
mother and the baby. Balancing these worries with the joy and anticipation of
pregnancy can be emotionally challenging.

• Social Pressures and Stigma: Women who become pregnant at an older age may
face societal pressures and stigma. They may encounter judgment or disapproval
from others who have different expectations regarding the "ideal" age for
motherhood. These external pressures can contribute to emotional stress and
affect the mother's well-being
 Preparing for an advanced age
Preparing for pregnancy involves taking steps
to optimize health and well-
Advanced being before conception
Age ( preconception care )
Pregnancy
Preparing for Activity
Advanced Age Discuss the importance of
Pregnancy preconception care and medical
consultation in advance age
pregnancy?
  Assessing Health and Risk Factors:
Preconception care allows healthcare providers to assess
the woman's overall health and identify any pre-existing
conditions that may impact pregnancy. This enables the
Preparing for Advanced development of a personalized plan to manage and mitigate
potential risks
Age Pregnancy  Addressing Medications and Vaccinations:
During a preconception consultation, healthcare providers
can review a woman's medications and make any necessary
adjustments. Some medications may need to be modified or
substituted to ensure they are safe for pregnancy.
Additionally, assessing a woman's vaccination status is
important to ensure that she is up to date with
immunizations that protect against certain infections that
can harm both the mother and the baby.
.
  Assessing Health and Risk Factors:
Preconception care allows healthcare providers to assess
the woman's overall health and identify any pre-existing
conditions that may impact pregnancy. This enables the
Preparing for Advanced development of a personalized plan to manage and mitigate
potential risks
Age Pregnancy  Addressing Medications and Vaccinations:
During a preconception consultation, healthcare providers
can review a woman's medications and make any necessary
adjustments. Some medications may need to be modified or
substituted to ensure they are safe for pregnancy.
Additionally, assessing a woman's vaccination status is
important to ensure that she is up to date with
immunizations that protect against certain infections that
can harm both the mother and the baby.
.
  Genetic Counseling and Testing:
Early consultation with a genetic counselor can provide
valuable information about the likelihood of genetic
Preparing for Advanced disorders and help parents plan for appropriate testing or
Age Pregnancy interventions.
 Optimizing Nutrition and Lifestyle:
Preconception care offers an opportunity to discuss
dietary and lifestyle factors that can influence fertility and
pregnancy outcomes. Healthcare providers can provide
guidance on maintaining a healthy weight, improving
nutrition, and avoiding harmful substances such as
tobacco, alcohol, and certain medications. Adequate
intake of folic acid, iron, and other essential nutrients can
be emphasized during this consultation.
  Preparing for Emotional and Psychological Well-
being:
Pregnancy at an advanced age can bring unique
Preparing for Advanced emotional considerations. A preconception consultation
Age Pregnancy can provide an opportunity to discuss any concerns or
anxieties and receive guidance on managing stress and
maintaining emotional well-being during pregnancy and
beyond. Mental health support and counseling resources
can be recommended if needed
 Patient Education:
Preconception care offers an opportunity for healthcare
providers to educate women about the importance of
early prenatal care, healthy lifestyle choices, and the
potential challenges associated with advanced maternal
age
 the role of healthcare professionals in providing
specialized care during advanced age pregnancies

Healthcare professionals play a crucial role in providing specialized care during

advanced age pregnancies
• Individualized Care Planning:
Based on the assessment, healthcare professionals develop an individualized care
plan for each woman. This plan takes into account her unique circumstances
• Management of Pregnancy Complications
• Collaboration with a Multidisciplinary Team
• Education and Information: Healthcare professionals play a crucial role in
educating women about pregnancy, childbirth, and postpartum care. They
provide information on topics such as nutrition, exercise, potential risks, and
available support services. This empowers women to make informed decisions
and actively participate in their own care.
Conclusion

• Delaying pregnancy is more common today and the trend is going up. Now, around 20% of total
births and 10% of first births in high-income countries are to people aged 35 and older.

• Risks associated with elder pregnancies necessitate careful consideration, genetic counseling, and all-
encompassing care

• A comprehensive strategy acknowledges the special requirements of older moms, promoting medical
and societal assistance and offering a chance for a more inclusive approach to reproductive health.
 References
• Cleveland Clinic medical professional. (2022). Advanced maternal age (geriatric pregnancy): Definition &
Risks. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/22438-advanced-maternal-age
• Cooke, C.-L. M., & Davidge, S. T. (2019). Advanced maternal age and the impact on maternal and offspring
cardiovascular health. American Journal of Physiology-Heart and Circulatory Physiology, 317(2).
https://doi.org/10.1152/ajpheart.00045.2019
• Correa-de-Araujo, R., & Yoon, S. S. (2021). Clinical outcomes in high-risk pregnancies due to advanced
maternal age. Journal of Women’s Health, 30(2), 160–167. https://doi.org/10.1089/jwh.2020.8860
• Garcia, M., Walker, K. F., & Thornton, J. G. (2022). Management of pregnancy complications in women of
advanced maternal age ... ScienceDirect. https://www.semanticscholar.org/paper/Management-of-pregnancy-
complications-in-women-of-Garcia-Walker/23618f7c174d83321a1b718aeffa888d2918bed9
• Glick, I., Kadish, E., & Rottenstreich, M. (2021). Management of pregnancy in women of advanced maternal
age: Improving outcomes for mother and baby. International Journal of Women’s Health, Volume 13, 751–
759. https://doi.org/10.2147/ijwh.s283216
Thank you