What Age Is Considered Advanced Maternal Age? Risks and Precautions You Should Know Before Getting Pregnant

According to the 2020 statistics from Taiwan's Ministry of the Interior, the average age at first marriage was 32.3 for men and 30.3 for women. The average age for women having their first child was 31.9. Among them, 31.6% of pregnant women were aged 35 or older, making advanced maternal age an increasingly common trend.

Despite the growing number of women becoming mothers at an older age, many people still have limited understanding of what defines advanced maternal age and the potential risks involved. This article will break down the key things women of advanced maternal age should be aware of. If you have further questions, feel free to consult with Lee Women's Hospital for more information.

What is the definition of advanced maternal age?

Medically speaking, women aged 34 and above are considered to be of advanced maternal age (AMA). As maternal age increases, so does the risk of chromosomal abnormalities, low birth weight, and other congenital conditions in the baby.
According to medical research, a 25-year-old mother has a 1 in 1,250 chance of giving birth to a baby with Down syndrome. By age 33, the risk rises to 1 in 250.

Is 35 considered advanced maternal age?
Read more：What Age Is Considered Advanced Maternal Age? A Closer Look at Pregnancy Challenges in Taiwan
 

What Fertility Options Are Available for Women of Advanced Maternal Age?

With ongoing advancements in reproductive medicine, couples of advanced maternal age who wish to conceive have more options than ever. In addition to trying naturally, assisted reproductive technologies such as IVF and other fertility treatments can also be considered as part of the family-planning journey.

1. If a woman has previously undergone egg freezing, the preserved eggs can be thawed, fertilized with her partner's sperm, and used for IVF. Using younger eggs increases the chances of a successful pregnancy.
2. IVF is often recommended for women over 35 who have been trying to conceive for at least six months without success. Today's IVF techniques can significantly boost the success rate for older couples and help shorten the time it takes to conceive.
3. This option is suitable for women of advanced age or those who cannot produce viable eggs. Donor eggs from healthy, younger women are used to increase the chances of a successful pregnancy and live birth.
4. Ideal for couples dealing with male infertility or azoospermia, donor sperm is carefully screened to ensure embryo health and improve the success rate.
5. Modern reproductive medicine offers various techniques to help improve fertility outcomes:
   • ERA (Endometrial Receptivity Analysis): Determines the optimal time for embryo transfer to improve implantation success.
   • PRP (Platelet-Rich Plasma): Uses the patient's own platelets to stimulate endometrial growth and improve uterine receptivity.
   • AI-Enhanced Embryo Selection: Employs artificial intelligence to evaluate embryo quality and grading for better selection.
   • PGT-A (Preimplantation Genetic Testing for Aneuploidy): Selects embryos with normal chromosomes, reducing the risks of miscarriage and multiple pregnancies.
   • Spindle View Imaging: A technique that helps avoid damage to the egg during ICSI (intracytoplasmic sperm injection), improving embryo implantation success.

What Are the Risks for Women of Advanced Maternal Age?

Women of advanced maternal age face a range of potential risks both during pregnancy and after delivery. That's why it's important to carefully consider and plan ahead before trying to conceive.

Pregnancy Risks for Women of Advanced Maternal Age：

• Miscarriage：According to Taiwan's Health Promotion Administration, the miscarriage rate for women aged 3539 is 24.6%, and it rises to 51% for those aged 4044. The older both partners are, the higher the risk of early pregnancy loss.
• Gestational Diabetes：Hormones secreted by the placenta can increase insulin resistance, making it harder for insulin to function properly. The risk of developing gestational diabetes increases with maternal age and is one of the key pregnancy complications that should not be overlooked.
• Preeclampsia：Changes in the cells lining blood vessel walls during pregnancy can cause elevated blood pressure and widespread swelling. This also reduces blood flow to the baby, potentially leading to intrauterine growth restriction (IUGR).
• Difficult Labor：Older mothers may experience longer or more challenging labor due to decreased pelvic flexibility and lower physical strength. This can make pushing during delivery more difficult. Additionally, the likelihood of needing a cesarean section increases if pregnancy complications arise.

Risks to Watch for at Different Stages of Pregnancy for Women of Advanced Maternal Age

Potential Risks for the Baby After Birth：

• Preterm Birth：According to Taiwan's Health Promotion Administration, among mothers aged 40 and above, 15.9 out of every 100 babies are born prematurely twice the rate seen in mothers aged 25 to 29.
• Low Birth Weight：For women aged 35 and older, 10.94% of newborns are born with low birth weight (1,5002,499 grams), and 1.3% are born with very low birth weight (under 1,500 grams)

Important Reminders for Women of Advanced Maternal Age

During the Preconception Stage：

• Couples of advanced maternal age are advised to undergo pre-pregnancy health screenings to check for any potential genetic conditions early on.
• If you're been trying to conceive for more than six months without success, it's recommended to consult a fertility specialist for a more in-depth evaluation.

During Pregnancy: Key Considerations for Women of Advanced Maternal Age

• Taiwan's Health Promotion Administration offers 14 routine prenatal check-up subsidies, as well as financial support for high-risk pregnancy genetic testing (such as amniocentesis) for women of advanced maternal age. These measures help ensure timely monitoring of both maternal and fetal health.
• According to Taiwan's Dietary Reference Intakes, women preparing for pregnancy and those in early pregnancy are advised to consume 600 micrograms of folic acid daily (important for fetal neural development, found in foods like dark leafy greens and legumes).
  In the later stages of pregnancy, women should aim to consume 45 milligrams of iron per day (crucial for producing hemoglobin for both mother and baby, found in foods like red meat and dark leafy vegetables).
• 懷孕期間孕婦應該維持均衡的飲食習慣，不需特別增重或減重，孕婦體重比孕前體重增加10-14公斤為宜。若孕婦的體重過低，會增加胎兒發育不良或早產的風險；若孕婦的體重過高，可能會有胎兒過大的風險。During pregnancy, it's important to keep a balanced and healthy diet. There's no need for intentional weight gain or loss????n overall weight gain of 1014 kg compared to pre-pregnancy weight is considered ideal. Being underweight may increase the risk of poor fetal development or preterm birth, while being overweight may raise the chance of having a baby that's too large.
• Pregnant women are encouraged to engage in 30 minutes of physical activity daily. This can help lower the risk of gestational diabetes and reduce the likelihood of complications during labor.
• It's best to avoid prolonged exposure to harmful substances such as tobacco (including secondhand smoke) and alcohol, as they may negatively affect fetal development and increase the risk of miscarriage.
• During times of widespread illness or pandemic, pregnant women should strengthen personal health measures wear a mask, wash hands frequently, and minimize exposure to reduce the risk of infection.

Things to Watch for During Labor：

In the later stages of pregnancy, it's important for women of advanced maternal age to stay attuned to their body. If you notice any signs of preterm labor or early labor, seek medical attention immediately.

Based on a doctor's assessment, if there are signs of stalled labor or difficulty during delivery, a cesarean section may be recommended to ensure the safety of both mother and baby.

Read more：Lee Womena's Hospital explains 3 common signs that labor has begun
 

Curious About Your Fertility?
Join our upcoming pre-pregnancy seminar perfect for those planning to conceive!

• Event Registration：https://ivf.ivftaiwan.com/news/44/

References：

• Advanced Maternal Age and the Importance of Timely Pregnancy - Health Promotion Administration, Ministry of Health and Welfare (HPA)
• More Support for Advanced Maternal Age: Prenatal Genetic Testing Subsidies - Health Promotion Administration, Ministry of Health and Welfare (HPA)
• Birth Notification Statistics - Health Promotion Administration, Ministry of Health and Welfare (HPA)