Radio Transcript

LIFE ISSUES NO. 1314

A BABY AT 40?


There's a lot of so-called conventional wisdom out there today
that would discourage any woman over 40 from getting pregnant and
having a child. Some of this centers around the fact that that
couple would have a very slightly higher chance of having a baby
with Down Syndrome or mongolism. Few know, however, that three-
fourths of all children born with Down Syndrome are born to women
who are under 35 years old. Well, let's look -- what are the odds
if you are over 35?

Well, first let's take a woman who's under 35. What is the
chance of her having a normal child without Down's? Well, it's 999
times out of 1,000. Now let's take a woman who's 40 years old.
What are her chances for a normal baby? 990 out of 1,000.
Clearly, those odds should be very reassuring if someone's around
40 years of age and does want another child.

Let's turn the page and ask another question. What about
physical complications to the woman who's pregnant after 40? Well,
actually, there are very few complications if she has kept herself
in good general condition. And that, of course, would be true at
any age.

I recall a major clinical report in the journal Obstetrics and
Gynecology entitled "Pregnancy After Forty Years of Age" by Dr.
Spellacy and colleagues. They did a very large study...511
pregnancies in women over age 40 out of a total of 40,000 women.
They studied them, compared the delivery outcome of the women over
40 with those who were between the ages of 20 and 30. And about
the only major problem they turned up was being overweight. Those
older women who were overweight had more high blood pressure, more
diabetes, more placenta praevia, that is, the afterbirth coming out
in front of the baby. They also had bigger babies, and,
interestingly enough, more males, and, sadly, more babies born
dead.

But for those women of normal weight, however, who were over
40, there was no difference in high blood pressure, no increase in
large babies, no increase in fetal death rate, no more distress at
delivery. Women of normal weight over 40 did have a little more
diabetes and had a few more Caesarean sections. But their infant
outcome was no different from that of the younger women.

So the conclusion of the study was that women who are over 40,
who are of normal weight, if managed by modern obstetric standards,
can expect a good pregnancy outcome and have no more fetal
complications than younger women.
There was one other factor that was statistically significant
- not greatly so - and that was that, if she had had many babies,
was what we call a "grand multipara", then there was a very
slightly increased chance of problems for both. But the bottom
line was that there is very little additional risk to mother and
baby for a woman pregnant over 40, outside of the major risk factor
of obesity.

So if you're 40, and you want a baby, go ahead -- the odds are
heavily with you, but you better watch your weight.


[07/18/96]