Just as times have changed, so has timing

April 20, 1993|By Carolyn Poirot | Carolyn Poirot,Fort Worth Star-Telegram

Sometimes you can fool Mother Nature, and a lot of baby boomers are doing just that when it comes to timing their own baby booms.

It may be more difficult for a woman approaching 40 to get pregnant (studies show fertility peaks at age 24), but once they conceive, older women often have healthier pregnancies and healthier babies than their younger counterparts.

"Typically, a woman postponing pregnancy past her 30th birthday is better educated than a woman who gets pregnant in her teens or early 20s," said Dr. Kenneth Moise, an obstetrician and gynecologist at Baylor College of Medicine in Houston. "She takes better care of herself, exercises regularly and eats a

healthier diet. She doesn't have children, so she has had more time to take care of her own health."

Times and women have changed since 1970, when fewer than 15,000 American women older than 35 became pregnant for the first time. Today, more than 50,000 women older than 35 become first-time mothers each year.

"Twenty years ago, the perceived risks of a 'middle-age' pregnancy seem to have been exaggerated," said Dr. Ronald Wapner, director of the Division of Maternal-Fetal Medicine at Thomas Jefferson University in Philadelphia.

"Older women are more likely to develop diabetes or high blood pressure," said Dr. Hugh Lefler, a Fort Worth, Texas, obstetrician.

"However, if she is in good health when she gets pregnant, there shouldn't be any unusual problems for the mother. The only thing that would concern me is the age of her eggs. Chromosomal problems are more likely with older mothers."

Chromosomal abnormalities are usually caused by an error in cell division in the developing fetus. The most common abnormality leads to the birth of a child with Down's syndrome.

The risk of Down's syndrome is about 1 in 900 in the general population. The risk increases to 1 in 270 in women who will be tTC at the time of delivery; at age 40, the risk is 1 in 80; and at age 45, the risk is 1 in 25, said Dr. Tom Howard, a Fort Worth perinatalogist who specializes in high-risk pregnancies.

Prenatal testing now is available for all known chromosomal abnormalities. It is also possible to test for some major genetic defects unrelated to the mother's age, including various forms of cystic fibrosis, sickle cell disease and other abnormal hemoglobins in the blood, Dr. Howard said.

Based on those tests, women are better able to decide whether to continue their pregnancies.

Some myths about older women and pregnancy should be dispelled, Dr. Wapner said. Dated medical literature suggests that older women might be at increased risk for separation of the placenta from the wall of the uterus or hemorrhage during pregnancy, for example.

But closer scrutiny shows that the problems are more likely to be related to the number of children a woman has had than to her age, Dr. Wapner said. A 40-year-old woman in her 10th pregnancy would be at greater risk than an older woman just starting a family, he said.

Finally, having children later can help keep you young, some mental health professionals say.

Women entering their 40s today may see themselves as younger simply because they still have young children at that age, said Dr. Nancy Warren, a psychologist at Baylor College of Medicine in Houston.

This is in contrast to women who turned 40 a generation ago. They were more likely to have had children early and to have worked only in the home. When they turned 40, the children were leaving, and they were unsure what was in store.

Today, women in their 40s are less likely than men to suffer a midlife crisis, and the empty nest syndrome comes much later, if at all.

"Women frequently have more diversity in their lives," Dr. Warren said. "Even if they work outside the home, their work is seldom the only focus of their lives, as it sometimes is with men."

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