First a career, then a child: the number of women who have children after the age of 30 is growing. Does this mean that the health risk for mother and child is also growing? Some say that it is no longer a problem to have a healthy baby after 35. The risk of giving birth to a disabled child increases with the age of the mother, say others. Both are true. However, the risks of late pregnancy can be largely avoided if the expectant mother consistently takes advantage of preventive care options and also checks her own blood sugar and blood pressure at home.
Malformation rate is greater
There’s no getting around it: Chromosomal defects increase as pregnant women age. This means that the offspring either gets too much or too little genetic information. The best-known abnormality is Down syndrome (trisomy 21), in which a child has three chromosomes 21 instead of two. Thus, a woman who has a child at age 37 carries 6 times the risk of giving birth to a child with Down syndrome than a 25-year-old. That is why doctors are obliged to inform every pregnant woman over 35, or when the parents are together 70 years old, about the possibility of so-called prenatal diagnostics. Methods such as chorionic villus sampling or amniocentesis are currently the only way to detect damage to the unborn child such as hemophilia, Down syndrome or open spine without a doubt. However, this carries risks: The embryo can be damaged by infection, and the risk of causing a miscarriage through this procedure is 0.5 percent. Chromosome testing is by no means mandatory. If the pregnant woman would refuse an abortion even in the case of a malformation or possible disability of her child, the chromosome examination is omitted.
Well adjusted for diabetes during pregnancy
Women who do not have offspring until they are beyond 30 have an increased risk of becoming diabetic during pregnancy. Diabetes that first shows up during the forty weeks of delivery does so inconspicuously. There is no circumstantial evidence. The expectant mother feels well, has no complaints. In most cases, there is only a sugar utilization disorder immediately after meals – experts refer to this as postprandial hyperglycemia – and otherwise common clinical symptoms such as thirst, increased urination and weight loss do not occur. Nevertheless, the child is at risk. In addition to an increased miscarriage rate, diabetic women give birth to more (2 to 3 percent) malformed babies. Women who are over 30 years old and overweight, and who have already had miscarriages or stillbirths, are more likely to be affected. The problem is that the usual tests using urine test strips detect only 2 percent of the actual 6 percent of women with gestational diabetes. Because sugar excretion via the kidneys changes, the test shows false positive results, for example. However, urine sugar can also be within the norm even though the pregnant woman has diabetes.
Problem gestational diabetes
More certainty is promised by the so-called oral glucose tolerance test (OGT), which is recommended between the 24th and 28th week of pregnancy. In the United States, it is done with all pregnant women, in Germany it has not yet been included in the maternity guidelines and is therefore not reimbursed by the statutory health insurance. Tip: If you do not have private health insurance, you should ask your doctor about this test and pay for it yourself. After all, it is an investment in the future! This is how it is done: The pregnant woman drinks a defined glucose solution (sugar solution). Afterwards, the blood sugar is determined. Limit values are: fasting: < 90 mg/dl, after 1 h: < 165 mg/dl, after 2 h: < 145 mg/dl, after 3 h: < 125 mg/dl. If two or more blood glucose values are abnormally high after the glucose drink, gestational diabetes is diagnosed. If fasting blood glucose is already elevated, the pregnant woman usually must inject insulin until delivery. Drugs that non-pregnant diabetics take are taboo for expectant mothers. They would harm the unborn child. Blood sugar must be well adjusted and strictly controlled. Why? Excessive blood sugar would literally fatten the unborn baby with sugar. The little person gains immensely in weight and size. At the same time, the organs are usually more immature than is appropriate for their stage of development. Attention!Anyone who has had gestational diabetes must expect the diabetes to persist after delivery or to reappear years later and then become permanent. To get on the track of the disease in time, it makes sense to do the glucose load test every one to two years.
Measure blood pressure regularly
A second condition that requires good control is preeclampsia, popularly known as pregnancy poisoning. About 5 to 7 percent of pregnant women develop high blood pressure, especially if they are overweight and older. If increased protein excretion in the urine and edema are added after the 20th week, the symptoms of preeclampsia are complete. In technical jargon, the symptoms are also called EPH gestosis. E, P and H are the first letters of the English names for the symptoms: E stands for edema (edema, water retention), P for proteinuria (protein excretion) and H for hypertension (high blood pressure). Over time, tissue damage to organs can occur due to the associated circulatory problems. The actual cause is unclear. A disturbed interaction between the maternal immune system and the foreign protein of the fetus is discussed as a trigger. As a result, certain parts of the placenta are not supplied with blood, and the child is inadequately nourished. 20 to 30 percent of all miscarriages are due to high blood pressure in the mother. But she is also at risk: The kidneys retain sodium and water and increase water retention in the body. Once liver activity is impaired, pain in the upper abdomen, nausea and vomiting become noticeable. There may also be dizziness, headaches and vision problems. The mother may experience brain spasms (eclampsia), and the lungs and heart may fail. Cerebral hemorrhage, kidney and liver failure are grouped together as HELLP syndrome. A blood pressure of 140/90 mmHg indicates mild preeclampsia; values above 160/110 mmHg indicate severe. In any case, it makes sense to measure your blood pressure several times a day. This way, you can intervene quickly if complications arise.
Nausea: unpleasant, but not ominous.
It is not always tangible illnesses that make Eva’s inheritance a complicated burden. Sometimes it merely results in one health inconvenience or another. Thus, about more than half of the expectant mothers resent the pregnancy in the first months. Small consolation: usually the spook is over after the 14th week at the latest. Nausea, often combined with vomiting, is an indication of a normally developing pregnancy. The reasons for these ailments are not fully understood. However, there seems to be a connection with HCG (human chorionic gonadotropin), which is formed in the outer shell of the amniotic sac and boosts the release of progesterone. From the second trimester, the placenta takes over the functions of HCG, which now gradually decreases. This is probably the reason why nausea subsides after about this time. The question of why not all pregnant women feel nauseous cannot be answered at this time. Tip: Since pregnancy usually hits the stomach in the morning after getting up, it should help to eat a snack in bed in the morning before getting up. It is best to prepare a small snack in the evening before going to bed, be it a rusk or an apple. Have several small meals throughout the day. If vomiting is frequent, drink plenty of fluids. Only if the nausea is severe should antiemetics (agents gg. nausea and vomiting) be used under medical supervision.
