2024-07-15 21:43:16
Many celebrities such as Cameron Diaz, Naomi Campbell, Janet Jackson, Virginie Efira and many others have democratized pregnancy between the ages of 40 and 50. We are seeing an increase in so-called late pregnancies.
These pregnancies considered at risk often require extensive medical monitoring to limit complications.
Fertility naturally decreases with age due to a decrease in ovarian reserve but also due to the degradation of the quality of oocytes (eggs produced during ovulation).
But paradoxically we are seeing an increase in the number of late pregnancies
According to INSEE, the number of late pregnancies tripled between 1980 and 2019, and the age of first pregnancy continues to increase. This is explained by societal reasons by prioritizing their professional career or in the context of new unions and an increase in infertility.
The main difficulties found are linked to a decline in quality and more chromosomal abnormalities.
The risk of miscarriage
A miscarriage is defined as the spontaneous termination of an intrauterine pregnancy; The number of abbots increases significantly with age; the risk is 50% per cycle after 42 years (according to the Ameli website) Natural selection of embryos takes place in the first trimester, in case of chromosomal abnormalities, miscarriage may occur. happen.
The risk of chromosomal abnormality
As previously described, with age there is an increase in the number of chromosomal anomalies at the oocyte and therefore embryonic level. We distinguish between numerical anomalies such as trisomy 21, 13 and 18 or structural anomalies.
For example, the risk of having a child with Down syndrome is estimated to be 1/100 after the age of 40 compared to 1/1500 at the age of 20.
Due to the importance of screening for these chromosomal abnormalities by ultrasound measurement of nuchal translucency between 11 and 14 weeks, HT21 is a blood test that measures nuchal translucency, hormonal dose and patient characteristics (age, weight , initiatives, etc.) allow risk calculation.
We can then offer a non-invasive diagnosis through a blood test looking for fetal DNA circulating in the mother’s blood and amniocentesis (sampling of amniotic fluid to rule out or confirm the diagnosis.
The risk of gestational diabetes
As a result of an increase in blood sugar during pregnancy, the prevalence is 14.2% after 35 years. Gestational diabetes can be accompanied by an increase in the weight of the child (macrosomy), an increase in the number of forceps cesarean sections, etc.
The risk of high blood pressure
There is an increased risk of high blood pressure corresponding to a blood pressure above 140/90 mmHg.
More complicated forms with renal and hepatic platelet damage can be accompanied by intrauterine growth retardation (insufficient baby weight) and preeclampsia. So a greater risk of cesarean sections and induced prematurities.
What follow-up for late pregnancy?
Fortunately, late pregnancy does not systematically rhyme with complications. On the other hand, prenatal consultation is recommended to inform patients, to identify existing medical conditions that may favor complications (for example diabetes, hypertension, overweight), limit add to the consumption of tobacco, alcohol, coffee
In some cases the risk of complications may be limited as well as folic acid with the introduction of aspirin.
Late pregnancy must be closely monitored by a gynecologist with clinical, biological and ultrasound monitoring, to maximize the future well-being of the mother and child.
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