Understanding Advanced Maternal Age: Pregnancy After 35

Everything you need to know about pregnancy after age 35, including risks, benefits, and how to optimize your health.

By Medha deb

Created on Oct 3, 2025

Everything you need to know about pregnancy after age 35, including risks, benefits, and how to optimize your health.

Advanced Maternal Age: What to Know About Pregnancy After 35

For many individuals and couples, starting or growing a family later in life is increasingly common. Advances in reproductive technology, shifting life priorities, and evolving societal roles have led to more people having children in their mid-30s and beyond. However, pregnancy at age 35 or older—commonly referred to as advanced maternal age (AMA)—brings important considerations for health and prenatal care. This article provides an evidence-based overview of advanced maternal age, covering risks, benefits, and proactive steps for a healthy pregnancy journey.

What Is Advanced Maternal Age?

Advanced maternal age is the medical term for being 35 years or older at the time of delivery or during pregnancy. Historically, this age was identified because the risk of certain complications, particularly chromosomal abnormalities like Down syndrome, increases after 35. While age 35 is a reference point, it is important to understand that risk increases gradually with age, not suddenly at this specific threshold.

Advanced maternal age = pregnant at 35 or older.
The term is used for clinical risk guidance and does not mean women under 35 have no risks or that those over 35 cannot have healthy pregnancies.
With good prenatal care and informed decisions, many people in this age group have successful outcomes.

Why Has the Average Age of Pregnancy Increased?

In many regions around the globe, notably throughout North America, Europe, and parts of Asia, the average age at which individuals have their first child continues to rise. Factors contributing to this shift include:

Career and educational advancement—Many choose to obtain advanced education or stability in their professions before starting a family.
Greater access to contraception, allowing more family planning flexibility.
Later marriage and changing social norms around family structure.
Advances in fertility treatments and reproductive medicine, which increase opportunities to conceive later in life.

Today, it is not unusual to see first-time parents in their late 30s or even early 40s. Still, the physiological realities of reproduction do not change, and individuals over age 35 benefit from tailored care and counseling.

Risks Associated With Advanced Maternal Age

While most pregnancies in people aged 35 and older progress without severe complications, certain risks are higher and deserve awareness and proactive management. These include:

1. Genetic and Chromosomal Abnormalities

Down syndrome and other chromosomal abnormalities become more common with age. For example, the risk of having a baby with Down syndrome is about 1 in 1,250 at age 25, 1 in 350 at age 35, and 1 in 100 at age 40.
Risk for conditions such as trisomy 18 and trisomy 13 also rises.
Prenatal screening and diagnostic tests can identify many of these conditions early in pregnancy.

2. Increased Risk of Pregnancy Complications

Gestational diabetes: Higher chance of developing diabetes during pregnancy, which can affect both mother and baby.
Preeclampsia: Risk of developing high blood pressure and potential damage to organs is higher.
Miscarriage (spontaneous abortion): The risk increases steadily with maternal age.
Stillbirth: Small but increased risk when compared to younger populations.
Cesarean delivery: Rate of C-sections is higher in this demographic, sometimes due to underlying complications or elective choice.

3. Fertility Challenges

Fertility naturally declines with age. By the mid-30s this decline speeds up due to decreased egg quality and quantity.
Reproductive technologies, such as in vitro fertilization (IVF), can increase chances of conception but are not a guarantee.

4. Fetal Complications and Birth Outcomes

Low birth weight
Preterm birth
Intrauterine growth restriction (IUGR): The baby grows more slowly than expected within the womb.
Higher likelihood of admission to the neonatal intensive care unit (NICU)

Why Does Risk Increase With Age?

Biologically, the ovaries house a finite number of eggs from birth. Egg quality diminishes over time, making genetic errors more likely during cell division. Older individuals are also more likely to have chronic health conditions, such as hypertension or diabetes, which can complicate pregnancy. Finally, the body’s ability to recover and adapt to the demands of pregnancy and childbirth lessens with time.

Benefits of Waiting Until 35 or Older to Have a Baby

Despite the recognized risks, there are

distinct benefits

for those who choose to have children at an older age:

Increased emotional and financial stability, often leading to a more supportive environment for parenting.
Access to better resources—including healthcare, education, and social support.
Potential for mature decision-making, with more life experience to draw from.
Some research suggests that children of older parents may benefit from more patient, mindful parenting approaches.

Potential Challenge	Potential Benefit
Higher risk of medical complications	Greater life/professional experience
Lower fertility	Potential for more financial stability
Increased chance of chromosomal anomalies	Established support networks
Longer recovery after delivery	Access to better prenatal care/resources

How Are Risks Managed?

With thoughtful care and attention, the risks associated with advanced maternal age can be actively minimized. Strategies include:

Preconception counseling: Consultation with a healthcare provider before trying to conceive can help identify and manage any underlying medical conditions.
Early and regular prenatal visits: Close monitoring during pregnancy is essential. Providers may recommend additional ultrasounds, genetic screening, and blood tests to detect complications early.
Managing pre-existing health conditions: Optimizing diabetes, blood pressure, thyroid function, and weight can support the best pregnancy outcomes.
Healthy lifestyle choices: Balanced nutrition, routine physical activity, avoiding tobacco and alcohol, and maintaining a healthy weight all support maternal and fetal health.
Screening for chromosomal abnormalities: Noninvasive prenatal testing (NIPT), first trimester combined screening, amniocentesis, and chorionic villus sampling (CVS) are available for at-risk pregnancies.

Common Screening and Diagnostic Tests for Advanced Maternal Age

Genetic counselors and obstetricians may recommend several tests tailored for pregnancies in persons over 35. Common options include:

First trimester screening: Combines a blood test and ultrasound to estimate the risk for chromosomal disorders.
Cell-free DNA screening (NIPT): Analyzes fetal DNA in the parent’s blood to screen for chromosomal conditions.
Amniocentesis: Obtains amniotic fluid sample, usually offered between 15–20 weeks if screening suggests an increased risk or by individual choice.
Chorionic villus sampling (CVS): Involves sampling placental tissue and is typically done earlier than amniocentesis, between 10–13 weeks, for early diagnosis.
Targeted ultrasound and anatomy scan: Typically performed at 18–22 weeks to assess fetal structure and anatomy.

All tests have particular risks, benefits, and reasons for when they’re advised. It is important to review options with your healthcare provider and genetic counselor. Many people with advanced maternal age opt for only non-invasive screens unless indicated otherwise.

Optimizing Your Health Before and During Pregnancy

Many of the steps that contribute to a healthy pregnancy are the same regardless of age, but are especially crucial for those over 35. Key recommendations include:

Schedule a healthcare check-up before trying to conceive to address issues such as high blood pressure, diabetes, thyroid problems, or obesity.
Take prenatal vitamins containing folic acid at least one month prior to conception to reduce risk of neural tube defects.
Stop smoking and avoid alcohol and illicit drugs, as these substances greatly raise risks of complications.
Discuss all medications and supplements with your provider to ensure they are safe during pregnancy.
Eat a balanced diet rich in plant-based foods, lean proteins, healthy fats, and whole grains. Nutrient needs, such as protein, calcium, iron, and vitamin D, are greater in pregnancy.
Engage in regular, moderate exercise (unless medically advised otherwise), which helps maintain healthy weight and reduces risks for complications.
Maintain a strong support system through friends, family, or pregnancy support groups.

What to Expect During Prenatal Care

While most prenatal visits and recommendations are similar regardless of age, those with advanced maternal age may receive extra attention in the following areas:

Frequent monitoring via ultrasounds and check-ups, especially during the third trimester.
Risk assessment and counseling for chromosomal anomalies.
More detailed discussions around delivery options and postpartum support, given the higher likelihood of C-section or assisted delivery.
Coordination of care if you have other health conditions or require specialist involvement.

Communication and shared decision-making are vital. Do not hesitate to bring up any questions or concerns to your provider at every step of the pregnancy journey.

Frequently Asked Questions (FAQs) About Advanced Maternal Age

Q: Can I have a healthy pregnancy if I’m 35 or older?

A: Yes, many people give birth to healthy babies after 35. Risk does increase with age, but proactive healthcare and healthy habits help minimize issues.

Q: Why is age 35 considered a threshold for risk?

A: This age is linked to increased risk for genetic abnormalities like Down syndrome. However, risks gradually increase over time, not all at once at 35.

Q: Is prenatal genetic testing required for people over 35?

A: No one is mandated to have any genetic test, but your provider will discuss the risks, benefits, and what information these tests can offer.

Q: Does advanced maternal age affect my ability to get pregnant?

A: Fertility does decline with age due to lower egg quality and quantity. It may take longer to conceive, and some people may need fertility assistance.

Q: Are there higher risks for my baby?

A: The risks of certain birth defects increase with parental age, but most babies born to parents over 35 are healthy. With proper screening and care, many complications can be managed.

Q: What should I do before trying to conceive?

A: Schedule a preconception checkup, optimize management of any existing conditions, start prenatal vitamins with folic acid, maintain a healthy lifestyle, and avoid tobacco and alcohol.

Key Takeaways

Advanced maternal age means pregnancy at 35 or older and is linked to specific health considerations.
Many people in this age group have healthy pregnancies and babies, especially with early, informed care.
Risks can be minimized with appropriate prenatal screening, regular medical visits, and healthy living habits.
Open communication with healthcare providers is critical to understanding and navigating your individual risk profile.

Helpful Resources for Expectant Parents of Advanced Maternal Age

Obstetrician-gynecologist (OB/GYN) clinics
Preconception and genetic counseling services
Prenatal education classes
Support groups for parents of advanced maternal age

Every pregnancy is unique, and age is just one factor in a much broader picture. With the right information and partnership with skilled healthcare providers, age 35 and beyond can be a wonderful stage for beginning or expanding your family.

References

Author

medha deb

Medha Deb is an editor with a master's degree in Applied Linguistics from the University of Hyderabad. She believes that her qualification has helped her develop a deep understanding of language and its application in various contexts.

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