Pregnancy – over 35 years

Key points about pregnancy over 35

  • More women over 35 years are having babies than ever before.
  • Most will have normal pregnancies; however, others may need special care before and during pregnancy.
  • There are more risk factors for women over 35 who are pregnant.
  • By working with your lead maternity carer and by having regular pregnancy visits, you will improve the likelihood of a healthy pregnancy.
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Once you have reached 35 years you have a greater chance of:

  • fertility problems
  • having a miscarriage or foetal loss in the second or third trimesters
  • developing diabetes or high blood pressure while pregnant
  • being constantly fatigued when pregnant
  • giving birth by caesarean section (surgery needed to deliver a baby)
  • having babies with chromosomal problems such as Down's syndrome
  • having multiple births.

As people get older, getting pregnant can become difficult. In general, if you are over 35 yrs old and not pregnant within 6 months of trying (with no contraception, regular sexual intercourse, and regular periods and menstrual cycle) then see your healthcare provider. They can advise if any tests and referral to infertility services are needed.

There are 2 commonly used screening options available for antenatal screening for Down syndrome and other conditions. Antenatal screening is particularly recommended if you are 35 years of age or older as the risk for conditions such as Down syndrome increases with increasing age of the mother.

The 2 options now available include first trimester combined screening and second trimester maternal serum screening. The screening tests are able to pick up most cases where there is an increased chance that you are carrying a baby with Down syndrome, Turner syndrome, Trisomy 13 or Trisomy 18. Occasionally it can also pick up that you could be at risk of a pregnancy-related health condition.

First trimester combined screening

This screening is available if you are less than 14 weeks pregnant and includes a blood test and an ultrasound scan. Results from both the blood test and the scan are combined with other information like your age, weight and baby's gestational age (how many weeks pregnant you are) to come up with a relative risk score.

  • The blood test is best taken at 10 weeks, but can be taken between 9 weeks and 13 weeks and 6 days.
  • The ultrasound scan (also known as a nuchal translucency scan) is best done at 12 weeks pregnancy, but it can be done between 11 weeks and 2 days and 13 weeks and 6 days.
  • Read more from the National Screening Unit.(external link) 

Second trimester maternal serum screening

This is a blood test, best taken between 14 and 18 weeks but it can be taken up until 20 weeks. This test looks for the levels of 4 analytes (chemicals) in your blood. From these levels, a low or increased risk score is calculated after considering your age and related factors. Read more from the National Screening Unit.(external link)

If screening shows there's an increased risk for a genetic condition (eg Down syndrome, Trisomy 13, Trisomy 18 or Turners' syndrome) you're likely to be offered further testing such as chorionic villus sampling (CVS) or amniocentesis

  • Chorionic villus sampling (CVS) is a prenatal genetic test where a small tissue sample is taken from the placenta to detect chromosomal abnormalities, genetic disorders, and other potential health issues in the developing foetus. Read more at Royal Australian and NZ College of Obstetricians and Gynaecology.(external link)
  • Amniocentesis is a test that studies amniotic fluid (liquid that surrounds the foetus in your uterus). It can help diagnose birth defects and other medical problems.

Pregnant! What do I need to know Healthify He Puna Waiora, NZ
Pregnancy screening tests and checks Healthify He Puna Waiora, NZ
First and second trimester combined screening test(external link) National Screening Unit (NZ), 2014
Planning for pregnancy(external link) Royal Australian and NZ College of Obstetricians and Gynaecology, NZ
Folic acid and neural tube defects (including spina bifida)(external link) HealthEd, NZ, 2021

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Credits: Healthify Editorial Team. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Dr Janine Bycroft, GP and Dr Lynda Gee

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