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Jonathan Morris
Jonathan Morris

Over 40 Mature Women [UPD]


Women in their 40s are more likely to develop gestational diabetes than women in their 20s or 30s. In the UK, all pregnant women who are considered at risk are offered a test for gestational diabetes during pregnancy.




over 40 mature women


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Pregnant women over 40 are more likely to have a very big baby (over 4.5kg or 10lb). Having a very big baby is often also linked to having gestational diabetes. Your midwife will arrange a scan to check the size of your baby if they think your baby is big.


Women over 40 are the most likely age group to have a caesarean birth. It is almost twice as likely that you will need a caesarean. This may be because the uterine muscle is less effective as we get older, particularly in first-time mums. If you have additional complications, such as a large baby, your healthcare team may discuss with you about having a planned caesarean.


"I had my second child when I was 41. It was a lovely experience, and I didn't have any issues that may affect older women. I don't regret for one moment having a child in my 40s. I felt so much more confident by then."


Estrogen-containing oral contraceptives restore menstrual regularity42 and prevent the development of endometrial hyperplasia and endometrial cancer.43 A placebo-controlled randomized trial of estrogen-containing oral contraceptives involving women with dysfunctional uterine bleeding showed that 80% of the participants in the treatment group had improvement in their bleeding pattern compared with those in the placebo group, although this study was not focused on women over 40.42 Unfortunately, few studies have examined the use of oral contraceptives specifically for perimenopausal bleeding. One study including 132 perimenopausal women showed that estrogen-containing oral contraceptives reduced the risk of blood clots and heavy bleeding.44 Oral contraceptives were shown in a small randomized trial to reduce menstrual bleeding by 43%.45 Randomized trials involving women with heavy menstrual bleeding have shown the efficacy of an oral contraceptive containing estradiol valerate and dienogest, and of a combined contraceptive vaginal ring in treating this condition.46,47 However, this oral contraceptive is not currently available in Canada. Furthermore, observational studies have shown that oral contraceptives can reduce menstrual blood loss and increase hemoglobin concentrations, and their use is supported in clinical practice guidelines.48,49


The use of the levonorgestrel-releasing IUD has been proven effective in treating heavy menstrual bleeding, including when it is associated with adenomyosis and leiomyomas.18,48,50 The levonorgestrel-releasing IUD is licensed in countries including the US, the UK and Canada for the treatment of heavy menstrual bleeding. Its use leads to a 97% reduction in menstrual blood loss by 12 months and has high satisfaction rates.51 Although irregular bleeding can occur initially, amenorrhea rates of 20% to 80% have been reported at 12 months.49,52 A systematic review and meta-analysis found the levonorgestrel-releasing IUD to be as effective as endometrial ablation in reducing heavy menstrual bleeding.53 In addition, a clinical trial involving women with heavy menstrual bleeding showed that the levonorgestrel-releasing IUD was comparable to hysterectomy in improving hematologic parameters and quality of life.54


Although a 2011 meta-analysis showed a significant risk reduction of ovarian cancer among women with BRCA1 and BRCA2 mutations who had ever used oral contraceptives,67 the evidence regarding the effect of oral contraceptives on the risk of breast cancer among women with these mutations was inconsistent.67,68 It appears reasonable for women with BRCA1 or BRCA2 mutations and no personal history of breast cancer to use oral contraceptives; however, the risks and benefits should be weighed by the woman and her physician.69


Results: One thousand nine hundred eighty-two women were 40 or older (mean age: 41.9) on the day of their delivery and compared to other 1,982 women who were aged between 25 and 35 years old (mean age: 30.7) Preeclampsia, gestational diabetes, were significantly higher in the study group (4.6 vs. 1.5% and 14.5 vs. 6.9%, respectively, p


The obstetrical complications studied are gestational hypertension (defined as systolic >140 mmH and/or diastolic >90 mmHg without proteinuria), pre-eclampsia (systolic >140 mmHand/or diastolic >90 mmHg associated with a proteinuria of 24 h >300 mg), gestational diabetes (defined according to the recommendations of the 2015 CNGOF), cesarean section (CS), admission of women to the intensive care unit during their pregnancies, postpartum hemorrhage (loss of more than 500 cc of blood within 24 h after vaginal delivery or CS) and blood transfusion.


Table 2 compares obstetric, fetal, and neonatal complications in univariate analysis. There is a significantly higher rate of obstetric pathology with 4.6% of pre-eclampsia for women aged 40 and over compared with 1.5% in the control group and 3.1 vs. 1.1% for gestational hypertension. There is also a significant difference for transfusion. With regard to gestational diabetes, there was 14.5% of women aged 40 and over, compared to 6.9%. However, no significant difference was found for postpartum hemorrhage and transfer to an intensive care unit. During the 11 years studied, no maternal deaths were observed.


Moreover, there is a higher risk of pre-eclampsia when the patient has some other risk factor such as twin pregnancy or medical history (hypertension and/or diabetes and/or VTE/vascular disease/lupus) (16, 17). Even more, these women with advanced maternal age are at higher risk of developing cardiovascular and nephrological diseases in the long term (18). In the case of tobacco, it has not been found as an independent risk factor, which can probably be explained by a significant underestimation of women reporting smoking during pregnancy.


The high proportion of cesareans in the study group of women over 40 is due to some contributing factors. On one hand, the percentage of scheduled cesareans is higher because there is a higher prevalence of uni or multi-cicatricial uterus.


The incidence of maternal complications is likely to increase over time due to increased maternal age. It will be difficult to reduce the incidence of these complications, but we can reduce the serious complications of preeclampsia, gestational diabetes (such as eclampsia, and macrosomia) through appropriate management (induce delivery before 41 weeks, close monitoring of the fetus) (27, 28).


Our study is yet limited by its monocentric character and retrospective aspect. In addition, Foch Hospital has an ART center, so our sample probably contained more patients using these techniques. However, we had the opportunity to have 18.2% of women over 40 using ART. This allowed us to highlight the significant increase in preeclampsia and prematurity in patients over 40 years of age who have used ART. After 44 years, 1 out of 2 women used the ART. This rate is surely underestimated because there is a large number of patients who voluntarily omit to declare their use of ART in particular the use of donated oocytes (33).


Advanced maternal age is a medical term to describe people who are over age 35 during pregnancy. Pregnancies have an increased risk for certain complications when the birth parent is 35 or older. Some of these complications are higher rates of miscarriage, genetic disorders, and certain pregnancy complications like high blood pressure or gestational diabetes.


Advanced maternal age pregnancy isn't treated much differently than a typical pregnancy. Your healthcare provider may suggest prenatal testing and monitor you more closely. Being mindful of your pregnancy symptoms and staying healthy becomes even more important when you're over age 35 because your risk for chronic conditions increases.


Healthcare providers have discovered that the biggest decline in fertility happens in your mid-to-late 30s. A decline in fertility means the quality and quantity of eggs in your ovaries decreases. This doesn't mean getting pregnant after 35 is impossible (it's very possible). It means 35 is the age when fertility starts to decline more rapidly and your chances for complications increase more significantly.


No, it's not too old to have a baby. The pregnancy rates of people having babies in their late 30s or 40s have increased across all races. Having a healthy pregnancy is dependent on how healthy you are overall, not just how old you are.


Most pregnancies over the age of 35 are healthy and successful. However, it's important to know the potential complications with advanced-age pregnancies. Talk to your healthcare provider about what genetic screening tests they recommend or what you can do to stay healthy if you are older than 35. In most cases, age during pregnancy is just a number. If you maintain a healthy weight, manage any conditions you have and listen to your healthcare provider, you will likely deliver a healthy baby.


At age 40 and above women have reduced fertility potential as compared to that seen in younger women. They also have substantially lower success rates with fertility treatments including in vitro fertilization (IVF).


The share of U.S. women at the end of their childbearing years who have ever given birth was higher in 2016 than it had been 10 years earlier. Some 86% of women ages 40 to 44 are mothers, compared with 80% in 2006, according to a Pew Research Center analysis of U.S. Census Bureau data.1 The share of women in this age group who are mothers is similar to what it was in the early 1990s. 041b061a72


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