Recently, the death of a 34-year-old mother at Peking University Third Hospital has drawn public attention. According to reports, the hospital stated that the pregnant woman suffered from gestational hypertension, also known as "preeclampsia," which planted a "time bomb" for the tragedy.For expectant mothers, it's not just preeclampsia—age itself is a high-risk factor, and older mothers face multiple hurdles. Gynecologists advise that older mothers should prioritize perinatal care.
Fertility declines sharply after age 35
According to Dr. Wulan, chief physician of obstetrics at Nanjing Maternal and Child Health Hospital, the first hurdle for older mothers is simply conceiving.
"The optimal childbearing age for women is 25–29, with the appropriate childbearing age spanning 25–35. Pregnancies occurring after age 35 are classified as advanced maternal age," Dr. Wulan explains. As women age, their fertility steadily declines. Generally, a 35-year-old woman has about 50% of the fertility of a 25-year-old, while a 40-year-old has only 50% of a 35-year-old's fertility.
"The decline in fertility among older mothers manifests as reduced ovarian reserve, insufficient endometrial receptivity (the uterine lining's ability to accept an embryo), and a shortage of high-quality oocytes and follicles. From an ovarian function perspective, whether conception is possible at all becomes a question."Ulan recommends that couples over 35 who have been trying to conceive without contraception for more than six months should promptly seek medical evaluation to identify potential causes. Preeclampsia: A Common Pregnancy Complication Beyond maternal health risks, the greatest concern for older mothers is the potential for birth defects.
Statistics show a marked increase in Down syndrome incidence among older mothers: 1 in 350 at age 25, 1 in 100 at age 28, and 1 in 35 after age 35. Infants with Down syndrome exhibit significant intellectual disabilities and physical abnormalities. Furthermore, the risk of Down syndrome increases with subsequent pregnancies.
Moreover, older mothers face higher risks of miscarriage and premature birth compared to younger women. Wu Lan explains: "During labor, older mothers often have weaker muscle strength, making them prone to uterine contractile insufficiency. Simultaneously, their cervixes may dilate poorly, frequently leading to cervical edema and difficulty in cervical dilation—conditions known as cervical dystocia. Such complications can easily cause fetal hypoxia and asphyxia."
Therefore, for older mothers, the ability to deliver a healthy baby safely also becomes a concern.
Increased risk of miscarriage, preterm birth, and difficult labor
"Gestational hypertension is a common condition unique to pregnant women, encompassing gestational hypertension, preeclampsia, eclampsia, chronic hypertension complicated by preeclampsia, and chronic hypertension. It severely impacts maternal and fetal health, ranking among the primary causes of morbidity and mortality for both mothers and newborns.""Ulan explained to reporters that besides gestational hypertension, complications like gestational diabetes and thyroid disorders are also relatively common.
Compared to younger mothers, older pregnant women face significantly higher risks of pregnancy complications. "Take the female patient at Peking University Third Hospital, for example. She was an older mother with underlying chronic hypertension, and her pregnancy exacerbated her condition, leading to organ involvement."
Ulan emphasized that older pregnant women with underlying conditions must undergo prenatal assessments and specialized management, with decisions on continuing the pregnancy made under medical guidance. "For instance, chronic hypertension can affect multiple organs like the heart, lungs, brain, and kidneys. We advise women to manage their conditions effectively before conceiving. If severe preeclampsia occurs, we promptly terminate the pregnancy to ensure the mother's safety."
Heightened Focus on Child Leads to Anxiety
Even after overcoming initial challenges, postpartum adjustment remains a hurdle for older mothers, particularly postpartum depression.
The risk of psychological disorders increases among older mothers."Older mothers experience intense conflict—they deeply desire a child yet harbor profound fear about their pregnancy," notes Ulan. Having worked with many advanced-age mothers, she observes that their hard-won pregnancies involve arduous journeys, leading them to focus far more intensely on their babies than younger mothers. This heightened attention often triggers various psychological issues.
The risk of postpartum depression peaks within the first week after delivery for older mothers. Initial symptoms manifest as anxiety, gradually evolving into depression.Ulan noted that some older mothers who deliver via cesarean section often have their infants sent to the pediatric ward for observation, resulting in mother-baby separation. When mothers are unable to see their babies for extended periods, they may experience excessive worrying, lethargy, crying, and other symptoms. Should such situations arise, mothers should seek psychological evaluation at the hospital to address these issues promptly.
High-Risk Signs for Older Mothers-to-Be
All expectant mothers should prioritize perinatal care, with older mothers-to-be requiring heightened awareness.
Ulan emphasized, "Pregnant women should undergo regular prenatal checkups: weekly after 36 weeks, biweekly after 32 weeks, and monthly before 32 weeks. Those with severe complications should increase visit frequency to detect and treat issues promptly."
How can older pregnant women recognize danger signs? "For instance, gestational hypertension often manifests as palpitations, dizziness, chest tightness, inability to lie flat while sleeping, blood pressure exceeding 140, significantly rapid weight gain, and reduced fetal movement. Gestational diabetes presents with increased thirst, increased appetite, increased urination, fatigue, rapid weight gain, and accelerated abdominal circumference growth. In such cases, pregnant women should monitor their urine sugar levels regularly..."
Why do older pregnant women face higher risks? Wu Lan illustrated, "It's like comparing an 18-year-old teenager to a 35-year-old middle-aged person in a running race. The middle-aged person's physical functions inevitably lag behind the younger individual. Therefore, younger women should seize their optimal childbearing years."