Risks of Pregnancy Over Age 30
Many women wait until later in life to have children. In the United States, birth rates for women in their 30s are at the highest levels in 4 decades. But an older mother may be at increased risk for things such as:
Miscarriage
Birth defects
Twins
High blood pressure
Gestational diabetes
Difficult labor
Some studies show that while there is a higher risk of pregnancy problems in older women, their babies may not have more problems than babies of younger women. This is more likely when women get prenatal care and give birth in a healthcare facility ready to care for high-risk mothers and babies.
Risk for chromosome problems
The risk for chromosome problems increases with the mother's age. The chance of having a child with Down syndrome increases over time. The risk is about 1 in 1,250 for a woman who conceives at age 25. It increases to about 1 in 100 for a woman who conceives at age 40. The risks may be higher. This is because many statistics only report live births. They do not note pregnancies with chromosome problems that ended due to pregnancy loss.
After having 1 child with Down syndrome, the chance of having another baby with Down syndrome is higher. After age 40, the recurrence risk for Down syndrome is based on the age of the mother at delivery. Most babies with Down syndrome are born to women under the age of 35. This is because women under the age of 35 have more babies than women over 35.
Risk for miscarriage
Some studies have shown a higher chance of miscarriage (early pregnancy loss) in older mothers. For all women, about half of first trimester miscarriages happen because of a chromosome problem in the baby. The risk of chromosome problems increase with the mother’s age. So miscarriage is also more likely.
Working with your healthcare provider
If you are pregnant and over the age of 30, talk with your healthcare provider about your health. Discuss plans for helping you and your baby have a healthy pregnancy.
Your healthcare provider may refer you to a genetic specialist or genetic counselor. He or she can explain the results of chromosome tests in detail. This includes what the risks may be in another pregnancy and what tests can diagnose chromosome problems before a baby is born.
Prenatal testing can help diagnose or rule out chromosome problems and other genetic birth defects. Testing may include:
Blood tests
Ultrasound, which uses sound waves to look at organs and other tissues in the baby
Chorionic villus sampling (CVS), a test done on a sample of the tissues around the baby
Amniocentesis, a test done on a sample of the amniotic fluid
Cell-free fetal DNA, which checks the mother's blood for chromosome problems
In recent years, Down syndrome has become more common, and children with Down syndrome are living longer. Read below for recent statistics on Down syndrome in the United States.
How many people are living with Down syndrome in the United States?
Babies:
- Down syndrome continues to be the most common chromosomal disorder. Each year, about 6,000 babies are born with Down syndrome, which is about 1 in every 700 babies born.
[Read summaryexternal icon] - Between 1979 and 2003, the number of babies born with Down syndrome increased by about
30%.
[Read summaryexternal icon ] - Older mothers are more likely to have a baby affected by Down syndrome than younger mothers. In other words, the prevalence of Down syndrome increases as the mother’s age increases. Prevalence is an estimate of how often a condition occurs among a certain group of people. To estimate the prevalence of Down syndrome, the number of pregnancies
affected by Down syndrome is compared to the total number of live births.
[Read summaryexternal icon ]
Children and Adults:
- In 2002, about 1 out of every 1,000 children and
teenagers (0 to 19 years old) living in the United States had Down syndrome. This means that in 2002 about 83,000 children and teenagers were living with Down syndrome.
[Read summaryexternal icon ] - Researchers estimated that in 2008 about 1 out of every 1,200 people (children, teens, and adults) living in the United States had Down syndrome. This means that in 2008 about
250,700 children, teens, and adults were living with Down syndrome in the United States.
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What is the life expectancy for people with Down syndrome?
- The life expectancy of people with Down syndrome increased dramatically between 1960 and 2007. In 1960, on average, persons with Down syndrome lived to be about 10 years old. In 2007,
on average, persons with Down syndrome lived to be about 47 years old.
[Read summaryexternal icon ] - Many factors can affect how long a person with Down syndrome lives.
- Sometimes infants with Down syndrome are born weighing less than 1,500 grams, or about 3.3 pounds. This is called “very low birth weight.” These babies are 24 times more likely to die in
the first 28 days of life compared to infants with Down syndrome of normal birth weight (between 2,500 grams and 4,000 grams, or between 5.5 and 8.8 pounds).
[Read summaryexternal icon ] - Black or African-American infants with Down syndrome have a lower chance of surviving beyond the first year of life compared with white infants with Down syndrome. More research is needed to
help understand why.
[Read summaryexternal icon ] - Infants with Down syndrome who also had a congenital heart defect (CHD) were five times more likely to die in the first year of life compared to infants with Down syndrome who did not have a CHD.
[Read summaryexternal icon ]
- Sometimes infants with Down syndrome are born weighing less than 1,500 grams, or about 3.3 pounds. This is called “very low birth weight.” These babies are 24 times more likely to die in
the first 28 days of life compared to infants with Down syndrome of normal birth weight (between 2,500 grams and 4,000 grams, or between 5.5 and 8.8 pounds).
- Between 1983 and 2003, about 93% of babies born with Down syndrome survived to one year of age. In the same time period, about 88% of babies born with Down syndrome survived to 20 years of age.
[Read summaryexternal icon ] - The
number of infants with Down syndrome that die before one year of age has declined over time. For example, between 1979 and 2003, among babies with Down syndrome, the rate of death during the first year of life declined from 8.5% to 5.0%, a decrease of about 41%. For comparison, the rate of death during the first year of life among all babies in the general population declined from 1.5% during 1979-1983 to 0.9% during 1999-2003, a decrease of about 40%.
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What other health conditions affect people with Down syndrome?
- About 50% of all babies born with Down syndrome are also born with a congenital heart defect. Babies with Down syndrome can be affected by a wide variety of heart defects. Many of these
conditions will need surgery, while some milder heart defects might go away on their own as the child grows and may only need to be monitored by a healthcare provider.
[Read summaryexternal icon ] - Compared to children without Down syndrome, children with Down syndrome are at higher risk for:
- Hearing loss (up to 75% may be affected)
- Obstructive sleep apnea, a condition where a person’s breathing temporarily stops while asleep (between 50 -75%)
- Ear infections (between 50 -70% may be affected)
- Eye diseases, like cataracts (up to 60%)
- Eye issues requiring glasses (50%)
- Heart defects present at birth (50%)
- Intestinal blockage at birth requiring surgery (12%)
- Hip dislocation (when the thigh bone slips out of the hip socket) (6%)
- Thyroid disease (a problem with metabolism) (4-18%)
- Anemia (red blood cells can’t carry enough oxygen to the body) (3%)
- Iron deficiency anemia (red blood cells don’t have enough iron to carry oxygen to the body) (10%)
- Leukemia (1%) in infancy or early childhood
- Hirschsprung disease (an illness of the gut that can cause constipation) (<1%)This article includes the American Academy of Pediatrics Health Supervision for children with Down syndrome from 2011.
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For more health care information for families of children with Down syndromeexternal icon
- Older adults with
Down syndrome have increased risk for developing Alzheimer’s disease.
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What are the healthcare needs and costs for people with Down syndrome?
- Among children aged 0-4 years with private insurance, average medical care costs were 12 times higher for children with Down syndrome compared to children of the same age without Down
syndrome.
[Read summaryexternal icon ] - For infants with Down syndrome, those born with a heart defect had, on average, health care costs that were five times higher in the first year of life than for infants with Down syndrome who did not have a heart defect.
[Read summaryexternal icon ] - A study used data from the 2005-2006 National Survey of Children with Special Healthcare Needs (NSCSHN) to look at the effects of Down syndrome on families. Responses from the NSCSHN questionnaire indicated the following:
- Nearly 60% of families of children with Down syndrome provided health care at home. Health care included practices such as changing bandages, care of feeding or breathing equipment, and giving medication and therapies.
- Over 40% of families of children with Down syndrome had a family member who stopped working because of the child’s condition.
- About 40% reported the child’s condition caused financial problems.
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