www.InSeasonMom.org
"support for first time moms over 35"

Biological Clock Ticks Longer

New StatsCan study shatters perception of older moms' risks

September 26, 2008
CARMELINA PRETE
THE HAMILTON SPECTATOR

Mothers and moms-to-be over 35 can fret less about the impact their biological clock has on their baby's health and development.
Although older moms face higher risks during pregnancy and childbirth, a new Statistics Canada report says their first-born children are generally as healthy as children born to younger moms.

The potential risks to older moms and their babies are well-documented -- including declining fertility and an increased risk of having a child with Down syndrome -- but less is known about the impact a mother's age has on her child's overall development.

A Statistics Canada report released Wednesday shows that first-born children of moms 35 and older were as likely to be in excellent or very good health at birth as children of moms aged 25 to 29.
The report comes as the rate of first-time moms over 35 has more than tripled in the past 30 years.

It's encouraging news to women such as Cynthia Wilson James who is part of the fast-growing population of first-time midlife moms.

As a first-time mom at 42 who had her second child two years later, the South Carolina writer felt so discriminated against as an older mom that she founded the website InSeasonMom.org to provide support and help allay the fears of women considering motherhood after 35.

"The biggest challenge I faced (while pregnant) and still face is not allowing negative comments about older moms to penetrate my spirit," the mother of a six- and four-year-old said in an e-mail interview.
"The Canadian report is timely and positive. I welcome the findings. Finally, a collection of modern data!"

The increased risk of complications women over 35 face in pregnancy and childbirth is well-known. But, the study noted, less is known about the impact a mother's age has on her child's development after birth.
The study also says that children of older mothers, defined as 35 and older, had similar incidences of asthma, and said their first word and took their first step around the same time as children of younger moms.

Both groups of children had similar average scores in physical aggression, emotional disorder, anxiety, hyperactivity and inattention, the study says. And vocabulary, number knowledge, copying and use of symbols were also similar.

There are a few exceptions. Children of older mothers were more likely to be late to sit up by themselves and to score lower on motor and social skills at ages two to three, as well as have lower positive behaviour scores at ages four to five.

The study's findings are relevant to more Canadian families as pregnancy over 35 becomes a growing trend.

According to a 2005 StatsCan study, 11 per cent of babies born in Canada were to first-time moms older than 35 -- a rate that has nearly tripled since 1987 when it was only 4 per cent.

At the same time, the rate of first births among women in their early 30s also increased significantly, from 15 to 26 per cent.

Dr. Edward Hughes, a McMaster University professor of obstetrics and gynecology and fertility specialist at Hamilton Health Sciences' Centre for Reproductive Care, said the growing trend of older motherhood means an increased demand in fertility care.

Both the number and age of patients is increasing at HHS's fertility clinic, he said.

Age is just one factor affecting a woman's ability to conceive. Are you a smoker? Are you overweight? Both factors can also hamper fertility, Hughes pointed out.

"Biology isn't black and white. Everybody is different," said Hughes, past-president of the Canadian Fertility and Andrology Society. "Individuals can have fertility declines earlier or later than that."

Robin Ryan, a career counsellor and author, was nearly 43 when she had her first and only child. She had preterm labour and went on 20 weeks of bed rest. She said several of her friends also got pregnant after 40 with their first child.

"All of us had complications," she said in an e-mail. "After 40, medical science can help you have a child, but it's rarely an easy pregnancy. The body isn't the same after 35."

Many women over 35 contemplating motherhood are likely aware of the increased risk they face: declining fertility, a higher likelihood to suffer from hypertension during pregnancy, to deliver prematurely or by caesarean section, and to suffer a miscarriage or an ectopic pregnancy.

But Dr. Irfane Khatib, an obstetrician and gynecologist at Sacred Heart Hospital in Wisconsin, said first-time older moms need to keep the increased risk in perspective.

For instance, he said, the chance of a woman in the general population having a child with Down syndrome is about 1 in 600, whereas the odds increase to about 1 in 250 for a woman over 35.
The risk has more than doubled, but the overall risk only jumped from about 0.17 per cent to less than 0.5 per cent.

"It's really perception more than anything else," Khatib said. "Our risk tolerance varies. For some, 1 per cent is too high, for others 0.5 per cent is too high.

"With women getting older, there is a little increase (of risk), but it's not significant. I would not tell a patient not to get pregnant because she is 36 years old."

First-time mother after 35

Pro

* More likely to take folic acid in preconception, which decreases odds of neural tube defects
* More likely to have carefully planned their pregnancy
* More likely to breastfeed
* More likely to feel settled and ready for childrearing
* Tend to have a higher level of education and income
* More likely to access prenatal care

Con

* Fertility declines significantly
* Success rates for assistive reproductive techniques decrease
* More likely to suffer from hypertension and gestational diabetes during pregnancy
* More likely to deliver prematurely or by caesarean section
* More likely to suffer a miscarriage, ectopic pregnancy or stillbirth
* Higher chance of chromosomal abnormalities in baby

Source: Reflecting on the trend: Pregnancy After 35: a collaborative project of Best Start: Ontario's Maternal, Newborn and Early Child Development Resource Centre and the Halton Region Health Department
(Reprinted with permission from The Hamilton Spectator)


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