Find out in this article
- Older childbirth and its pregnancy probability
- Risks in Pregnancy at Age 40
- Points to remember when getting pregnant after 40
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If I get pregnant at 40, will I have a late birth?
Although there is no clear definition of late childbirth, the Japan Society of Obstetrics and Gynecology states that ``first-time mothers over the age of 35 are called elderly first-time mothers''. European and American guidelines also explain that late childbirth in the reproductive age is 36 years or older, when a decrease in fertility becomes apparent1). From the above, if you get pregnant at the age of 40, you can generally say that you are giving birth at an old age. As you get older, your risk of miscarriage and birth defects increases. Please explain that if I become pregnant at the age of 40, I will give birth at an advanced age.
chances of getting pregnant at age 40
Women in their 30s and 40s are getting married due to the advancement of women in society. As a result, more and more women are getting pregnant in their 30s and 40s. However, in reality, the probability of getting pregnant decreases compared to the 20s, which is said to be the age of pregnancy. From around the age of 35, the probability of natural conception begins to decline, and in the 40s, the natural conception rate per cycle is said to be only 5%. In addition, the probability of pregnancy within one year is close to 100% in the early 20s, but decreases to the 60% level in the late 30s and beyond.
What are the risks of getting pregnant at 40?
As you get older, the risk of miscarriage, dystocia and premature birth, chromosomal abnormalities, and postpartum uterine inversion increases . Pregnancy hypertension and gestational diabetes may also require treatment during pregnancy. I will explain each one.Increased miscarriage rate
Miscarriage rates increase with age. A survey in the United States reported that the miscarriage rate for pregnant women aged 35 to 40 is twice as high as that for pregnant women under 35, and 2.4 times for those aged 40 and over2). Miscarriages in early pregnancy are said to be caused by chromosomal abnormalities, but the number of follicles in the ovary decreases sharply with aging. As the number of follicles decreases, menstruation becomes irregular, and the frequency of chromosomal abnormalities in eggs is said to increase.
Difficult birth/premature birth
Another concern is the increased risk of dystocia and premature birth. From 37 weeks 0 days to 41 weeks 6 days of pregnancy is called the full-term period, and it is said that the baby is fully grown and can be out of the womb. It is defined as premature birth if it is born between 22 weeks 0 days and 36 weeks 6 days before that. It has been reported that the risk of premature birth increases in pregnant women over the age of 40. Also, the birth canal and the cervix, through which the baby is born, become harder with age. This makes it easier for the baby to pass through, which increases the risk of a difficult birth.
hypertensive syndrome of pregnancy
Gestational hypertension is an obstetric complication that increases with age. It has been reported that the incidence of gestational hypertensive syndrome is about 8% for mothers over 40 years old, which is almost double that for pregnant women under 35 years old2). In addition, 18% of maternal deaths are said to be caused by cerebral infarction or cerebral hemorrhage, and it is known that 28% of cerebral hemorrhage cases had gestational hypertension as a background 2). If pregnancy-induced hypertension becomes severe, there is a possibility that both the mother and the baby will be in a dangerous state, such as poor growth of the baby and an increased risk of illness in which the placenta detaches from the wall of the uterus before delivery and oxygen is not delivered to the baby. there is.
gestational diabetes
Gestational diabetes is a disorder of glucose metabolism that is first discovered during pregnancy. If you have been diagnosed with diabetes before pregnancy, or if you are diagnosed with diabetes clearly unrelated to pregnancy during pregnancy, you may be diagnosed with gestational diabetes. not included. If the mother has high blood sugar, the baby will also have high blood sugar, which can lead to various complications. On the mother's side, abnormalities in the amount of amniotic fluid occur, and gestational hypertension tends to occur concurrently. On the baby side, macrosomia, hypoglycemia after birth, and hospitalization due to it may occur.
chromosomal abnormality
Chromosomal abnormalities can be broadly divided into numerical abnormalities and structural abnormalities. Numerical abnormalities are abnormalities in which there are 3 or 1 chromosome instead of 2 pairs. Structural abnormalities are those in which the number of chromosomes is normal, but some are missing or rearranged. Of these, the risk of numerical abnormalities increases with age. For example, if a woman becomes pregnant at the age of 40, the fetal risk of developing Down's syndrome is said to be 1/100, which is significantly higher than the risk of developing Down's syndrome at the age of 20 (1/1,700)2). The risk of structural abnormalities does not increase with age.
Insufficiency of uterine involution
Insufficiency of uterine remodeling means that the uterus does not contract well after delivery and does not return to its pre-pregnancy size. In the case of old childbirth, it is said that this uterine remodeling failure is more likely to occur. In addition, uterine incompetence is more likely to occur in cases where delivery takes a long time, multiple births, and large babies, and age is not the only cause. However, when giving birth at an older age, the birth canal and cervix may harden and delivery may take a long time, increasing the risk of uterine remodeling failure.
5 things to keep in mind when getting pregnant after 40
Pregnancy after age 40 increases the risk of complications, miscarriage, and fetal chromosomal abnormalities. However, being too anxious and nervous can also be stressful and adversely affect the continuation of the pregnancy. Here are some things to keep in mind when trying to conceive after 40.Intake of folic acid
Although it is difficult to completely eliminate the risk of giving birth at an older age, one way to reduce the risk as much as possible is to take folic acid before pregnancy. Folic acid is effective in preventing fetal neural tube defects, and recent studies have reported that it reduces congenital heart disease, abdominal wall rupture, cleft lip and palate, and spontaneous abortions 2). The Ministry of Health, Labor and Welfare recommends taking 400 μg of folic acid per day from one month before conception to three months after conception. As long as you don't know when you will get pregnant, women who wish to become pregnant should take it in advance.
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Do I Need Folic Acid Before Pregnancy? How much do you take? Introducing how to choose folic acid supplements for pregnancy
nutritionally balanced diet
A well-balanced diet is very important for both those who want to become pregnant and those who are currently pregnant. While eating a variety of foods in a well-balanced manner, especially eat whole grains, omega-3 fatty acids, fish, and soybeans, and try to reduce trans-fatty acids and red meat3). Trans fatty acids may impair ovulatory function by being involved in inflammation and insulin resistance4). A Mediterranean diet, high in vegetable oils, fish, legumes, vegetables, and low in snacks, was reported to increase pregnancy rates by 40% in couples undergoing embryo transfer or artificial insemination. Five).moderate exercise
Maintaining a proper weight through moderate exercise improves metabolic function and hormone balance, and leads to increased fertility, so please be proactive. Moderate exercise has been reported to increase the chances of conception regardless of BMI6). Examples of moderate exercise include walking, gardening, and yoga. If it is walking, it is recommended because you can start easily without any tools to prepare. It is said that it is effective to continue for about 30 minutes every day.Watch out for rapid weight gain
It is generally said that total weight gain during pregnancy should be kept between 7kg and 12kg. When morning sickness is over, you may have a strong appetite and may end up eating too much, so be careful. Sudden weight gain during pregnancy can lead to gestational diabetes and gestational hypertension. Avoid sudden weight gain by eating a balanced diet and exercising regularly. Also, be aware of eating with an empty stomach and chewing well, and be careful not to take too much salt.
do not accumulate stress
It is no exaggeration to say that today's women are busy and stressed out. However, it has been pointed out that accumulating stress during pregnancy may affect not only the mother but also the fetus. There is concern that maternal stress may increase the risk of low birth weight and attention-deficit/hyperactivity disorder (ADHD) in newborns7).keep your hormones in order
In order to increase the pregnancy rate and prevent various troubles during pregnancy and after childbirth, it is important to adjust the hormonal state on a daily basis. However, hormones are not visible, so you cannot judge by yourself whether they are in place or not. In addition, many people who want to get pregnant or who are trying to get pregnant may want to know their hormone status and ovarian age. You can check it at a clinic that specializes in fertility treatment, but you can check it at home if you use a hormone test kit.
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summary
In general, pregnancies after the age of 35 are said to be late births. As a result, pregnancy at the age of 40 can be painful, and you may be plagued by various troubles during pregnancy. Compared to those who got pregnant at a young age, they may get tired more easily, or their metabolism may slow down, making it difficult to control their weight. The risk of complications and chromosomal abnormalities increases with age. However, by reviewing your eating habits and daily habits, it is quite possible to increase your chances of getting pregnant even at the age of 40 and to continue a healthy pregnancy.
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References
1) Japan Society of Obstetrics and Gynecology, “Obstetrics and Gynecology Practice Guidelines – Gynecology Outpatient Edition 2020” https://www.jsog.or.jp/activity/pdf/gl_fujinka_2020.pdf
2) “Problems associated with late pregnancy” https://www.jstage.jst.go.jp/article/kyorinmed/47/1/47_77/_pdf
3) Diet and female fertility: doctor, what should I eat? https://www.sciencedirect.com/science/article/pii/S001502821830428
4) Dietary Fat Intake and Fecundability in 2 Preconception Cohort Studies https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5860620/
5) The preconception Mediterranean dietary pattern in couples undergoing in vitro fertilization/intracytoplasmic sperm injection treatment increases the chance of pregnancy https://www.fertstert.org/article/S0015-0282(09)04338-6/fulltext
6) A prospective cohort study of physical activity and time to pregnancy https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3340509/
7) “Stress vulnerability induced by prenatal stress stimulation and 5-HT neural dysfunction in the brain” https://www.jstage.jst.go.jp/article/fpj/147/4/147_212/_pdf
