A new study has reported that women who give birth over the age of 35 could be at risk of a number of health problems, including gestational diabetes.
Many of the risk factors associated with pregnancy are more harmful when the expectant mother is over 35, according to Reeta Lamminpää’s doctoral dissertation report Advanced Maternal Age, Pregnancy and Birth.
The study was carried out at the University of Eastern Finland, and looked at the risks associated with obesity, smoking, gestational diabetes and pre-eclampsia (high blood pressure during pregnancy) are higher in advanced maternal age than in younger expectant mothers.
Mothers giving birth over the age of 35 may have an increased risk of developing gestational diabetes
Advanced maternal age refers to women giving birth at the age of over 35. In the western world, advanced maternal age has been a clearly growing trend in recent years. In Finland, one in five women giving birth in 2013 were aged over 35.
The study looked at around 700,000 expectant mothers and their new-born children by combining figures from 1997-2008 - available from three national-level registers: the Finnish Medical Birth Register, the Finnish Hospital Discharge Register and the Finnish Register of Congenital Malformations.
The link between age and an additional risk factor on complications during pregnancy and the outcome of childbirth were studied in four risk groups: expectant mothers diagnosed with pre-eclampsia, expectant mothers who smoked, expectant mothers who were overweight and obese, and expectant mothers diagnosed with gestational diabetes.
Gestational diabetes usually develops in the third trimester (after 28 weeks) and in most cases disappears after the baby is born. However, women who develop gestational diabetes are more likely to develop type 2 diabetes later in life.
The outcome of childbirth in advanced maternal age was compared to the outcome of younger mothers, aged under 35.
In all of the four risk groups, the risks associated with pregnancy and childbirth were higher in advanced maternal age than in younger expectant mothers. The age of over 35 as such was not a significant independent risk factor, but the risks increased when advanced maternal age was combined with an additional risk factor.
In expectant mothers over 35 who were overweight or obese and diagnosed with gestational diabetes, pre-term birth, foetal death, large-for-gestational-age infant and pre-eclampsia in particular were more likely. In addition, being overweight was linked with an increased risk of needing a caesarean section in advanced maternal age.
Early recognition of the risk groups would make it possible to guide mothers to further treatment at an earlier stage and, consequently, could help reduce the risks of the mother and the unborn child alike.
For the majority of expectant mothers aged over 35, there are no complications in pregnancy and childbirth; however, earlier research has shown they were at a higher risk than younger expectant mothers.
While the link between maternal age and risks and birth outcomes has been widely researched; there have been few studies on the effects of advanced maternal age in different risk groups.
Margery Morgan, Consultant Obstetrician and Gynaecologist at Singleton Hospital, Swansea, said: “Advanced maternal age is well known to be associated with gestational diabetes. This makes sense as the pancreas becomes less effective in everyone as they get older. The latest NICE guideline for diabetes in pregnancy does not recommend screening older mothers for gestational diabetes because of the numbers that would be eligible.”
The NICE guideline on diabetes in pregnancy can be read here
Advanced Maternal Age, Pregnancy and Birth can be read here
Read more about gestational diabetes at the NHS page here
Read the DRWF leaflet What is diabetes? here