One-fourth of pregnant women above 35 risk miscarriage: Study

NOV 2016:

Age is often the number that pushes women into the high risk category in pregnancy. And a new finding has reinforced the concept of the biological clock.

A study of 500 women admitted to the Institute of Social Obstetrics and Kasturba Gandhi Hospital for Women and Children in Triplicane found the risk of miscarriage among women above 35 was 25%, significantly higher than those between 20 and 34 which stood at 8.4%.

A three-member team undertook the year-long study which recently appeared in the International Journal of Scientific Research. It found that of the 3,486 pregnant women admitted to the hospital, 250 were above 35 and classified as "high risk" in maternal medicine. The researchers compared the progress of these patients with another 250 women aged between 20 and 34 against parameters like duration of infertility, recurrent miscarriages and antenatal complications such as gestational diabetes, hypertension and heart diseases.

Though there are several studies from developed countries linking higher incidence of obstetric complications to age, research in the country is nascent despite women increasingly delaying pregnancy , said Dr Subha Sivagami Sengodan, from the department of obstetrics and gynaecology at Government Thoothukudi Medical College and Hospital, who led the study . Hospitals have also been quick to capitalise on this trend by offering fertility treatments and "100% high-risk pregnancy care".

Experts estimate that at least 60% of urban women now conceive for the first time between 30 and 35 years. Gynaecologist Dr Geetha Haripriya said the most common reason for them to delay pregnancy is career. "Fertility declines with advancing age but now women in their early to mid 30s are also facing complications due to fertility issues and other medical conditions related to lifestyle. And at least 80% of them require fertility treatment just to be able to conceive, which is the first big challenge," she said.

Besides high risk of miscarriage, the study found that gestational diabetes and hypertension, both chronic and pregnancy induced, are more after the age of 35 compared to the younger group. "Some of them also had a history of diabetes and systemic hypertension owing to high BMI and obesity ," said Dr Sivagami. The incidence of spontaneous abortion was also high because of high blood pressure and aging of uterine blood vessels.

It isn't just the mother who faces high risks: Preterm delivery was higher in the older group (37.4% versus 25.3% in the younger one), with many of them being required to be admitted to the neonatal intensive care unit for preterm care and monitoring of sugar levels.

Gynaecologists, however, maintain that most of these conditions are manageable if the women were screened early and periodically . "When a woman chooses to get pregnant is her decision, but they need to start planning early," said gynaecologist and fertility expert Dr Priya Selvaraj.While freezing embryos is an option, many go in for natural conception or opt for other assisted reproductive technology, she said, recommending preconception, genetic counselling and increase folic acid intake for four to six months in advance. TOI