How worried to be about birth defects with advanced maternal age?

[Anonymous]

I had children at 32, 35 and 37. The child I had at 32 has a chromosomal disorder and the ones I had subsequently do not. It’s always a risk.
For what it’s worth, I just took all my children to a museum, out to lunch today and to an amusement park yesterday, everyone had a blast. I don’t actually see what having a brother with a chromosomal abnormality “does” to *them*.

[Anonymous]

We had ours at 35 and 39, no issues.

[Anonymous]

I was 36 when I had a Down syndrome pregnancy. It was a devastating diagnosis to get, but after doing some research and speaking with a genetics counselor, we decided to continue the pregnancy. My husband and I were both 37 when the baby was born. Although our son is delayed and we have a lot of medical appointments and therapies, I don't regret our decision to have him. He is a happy little boy who has brought so much joy to our lives. Yes, I worry about his future, but we have legal and financial arrangements in place that will hopefully allow him to lead a comfortable life after we're gone without becoming a burden to his brother.

However, the issue isn't whether you want your child to have a disability (no one does) or whether you could handle a disability if one happened (you could), but different levels of risk tolerance between you and your husband. You are very unlikely to be in the same situation as me (less than 1%), but it's not impossible. If you decide to proceed with trying for another child, you and your husband need to have a discussion about worse-case scenarios and how you would handle them. If you can't agree, then the answer is no, unfortunately.

[Anonymous]

I had my children at 33, 35 and 39. When I was pregnant with my first (he is an adult now), I had some kind of test for CF, I think, that also showed false positives for Down's. My doctor had warned me of this flaw in the test, but she said the only way to be sure was to have an amnio. I did, and it was perfectly normal. During the process, the geneticist asked us lots and lots of questions about our histories and determined that the only thing to test for was Down's. With the latter 2, I chose not to have an amnio and, as a result, had no genetic testing other than an enhanced ultra-sound. Children have no anomalies.

Here's what really sticks in my mind, though. I had read somewhere - and I'm making these specific numbers up for illustrative purposes, but the spans are similar - that a 39-year-old woman has a 1 in 150 chance of having a child with Down's and a 1 in 70 chance of having spontaneous twins. When we first heard my third child's heartbeat, I asked my doctor to assure me there was only one, and she replied, of course, there's only one, you're not undergoing fertility treatments, don't be silly. It struck me as odd that concerns over the greater risk (spontaneous twins) were silly, but the lower risk was treated as almost likely.

[Anonymous]

I got testing done. CVS. I found out that all was good with health and also the gender of the baby. I had a very compassionate and DCUM-famous doc in shady grove. I would have aborted if I knew of any disability. I could not subject my child to a hard life deliberately.

I was also super strict about my diet and adhered to a strict diabetic and nutritionally balanced diet from the very first days. I ate a whole lot of veggie and fruits, frequent small meals, whole grain, minimally processed, home made food, organic everything, lots of water. Not even a bite of junk or a sip of anything other than water. I have a lot of will power. My DH really helped and a big champion. I had a healthy beautiful baby boy. Our pride and joy!

[Anonymous]

Anonymous wrote:I was 36 when I had a Down syndrome pregnancy. It was a devastating diagnosis to get, but after doing some research and speaking with a genetics counselor, we decided to continue the pregnancy. My husband and I were both 37 when the baby was born. Although our son is delayed and we have a lot of medical appointments and therapies, I don't regret our decision to have him. He is a happy little boy who has brought so much joy to our lives. Yes, I worry about his future, but we have legal and financial arrangements in place that will hopefully allow him to lead a comfortable life after we're gone without becoming a burden to his brother.

However, the issue isn't whether you want your child to have a disability (no one does) or whether you could handle a disability if one happened (you could), but different levels of risk tolerance between you and your husband. You are very unlikely to be in the same situation as me (less than 1%), but it's not impossible. If you decide to proceed with trying for another child, you and your husband need to have a discussion about worse-case scenarios and how you would handle them. If you can't agree, then the answer is no, unfortunately.

+1
Great post!

[Anonymous]

Anonymous wrote:I got testing done. CVS. I found out that all was good with health and also the gender of the baby. I had a very compassionate and DCUM-famous doc in shady grove. I would have aborted if I knew of any disability. I could not subject my child to a hard life deliberately.

I was also super strict about my diet and adhered to a strict diabetic and nutritionally balanced diet from the very first days. I ate a whole lot of veggie and fruits, frequent small meals, whole grain, minimally processed, home made food, organic everything, lots of water. Not even a bite of junk or a sip of anything other than water. I have a lot of will power. My DH really helped and a big champion. I had a healthy beautiful baby boy. Our pride and joy!

Oh, I was 42. Had a 2 previous GD pregnancies. Hard to manage even with insulin injections. Really hard labor and tough recovery in both. Healthy kids. I would have had to wait for amnio but not CVS. I did not want to wait if the result was not good. At that point, I was not feeling pregnant. I was mainly feeling very ill. I had not allowed myself to be emotionally attached to the baby until I got all clear.

[Anonymous]

Get an amnio and end the pregnancy if there’s a problem.

[Anonymous]

Anonymous wrote:I had mine at 35 and 38. You do the blood test at 8-10 weeks and then the scan at 11-13 and it gives you an idea. You can’t screen for autism which is a big deal imo. Sounds like a third isn’t for you.

+1 I had mine at the same ages. With my first, at 35, there was no cell-free DNA blood test available yet and the 12 week scan showed a slightly large nuchal fold, so we had an amnio and additional monitoring through the third trimester. DS was healthy, but it was an incredibly anxious time. With my 2nd, we had all the early blood tests, great scans, non stress tests in the weeks leading up to her birth. Everything looked great, easy pregnancy, healthy baby. She does have ASD, diagnosed at age 4. She's a lovely kid and is doing well (in some ways better than our older NT kid, to be honest!), but of course DH and I wonder if our ages contributed to her ASD. We have zero regrets but we also decided not to have another child, even though we originally wanted three.

I know it's very typical in this area to have kids in mid-late 30s and beyond. Statistics and anecdotal evidence are still strongly on your side! But there are people for whom statistics will not be on their side, and will receive an unfavorable diagnosis. Will your marriage and existing family be able to weather it if you decide to terminate or need to manage a child with special needs? Life is a crapshoot. Loss and change can happen at any age, it's really the question you ask yourself when you consider parenting to begin with, but it becomes more statistically relevant the older you are. We asked the question before DS1 and DD2, and then after DD2 when we asked the question again we knew the answer would be no, and we were going to be a family of 4.

[Anonymous]

The plural of anecdote is not data. OP you should take a look at the data, think about the fact that testing will only pick up some things during pregnancy and then make a decision. 35/36 is still relatively young, I would go for it - but I am not you.

[Anonymous]

I had genetic counseling when pregnant at 36, and the amino. It’s covered by insurance.

This was a while back, but l remember the genetic counselor showing me some charts that should also be available online. Like the chance of Down’s syndrome - the curve goes way up after 37. Below that chance is low. Talk to your doctor

https://www.researchgate.net/figure/Risk-for-Down-syndrome-at-birth-by-maternal-age-and-ethnicity-United-States-1989-1991_fig1_12251945

[Anonymous]

Anonymous wrote:I have two beautiful children that I had at ages 31 and 33. I am 35 now and my husband and I are arguing over whether to have a third. I desperately want one more, but he leans no (with the door still open enough to give me hope), and one of his reasons is that he's so worried about the risk of a baby with something wrong with it (chromosomal, special needs, birth defect etc). He says it's a prospect he can't even bear, especially because of how unfair that would be to the older two.

I would like to give him data or reassurance, but I can't deny that the fear seeps into me, too, not to mention how guilty I'd feel if something did happen after he was so open about his fear.

Can anyone share resources for this, or know off-hand what the general risks would be? By the time this baby would be born we would be 36 (almost 37) and 37 (DH). We have no family history of health issues. We did genetic testing and are clear. We have two healthy, full term, normal weight babies with healthy noneventful pregnancies.

Thank you!

To be honest, kids suck lot of energy and resources, stick with what you have. You are twice blessed, why take unnecessary risks?

[Anonymous]

My story - I had always conceived immediately, every time for 4 pregnancies. However, at 36 my really awful journey started with a 15 week loss then more losses, IVF where 66% of the embryos were abnormal.

I had no way to know that I would be completely infertile after 35 and essentially producing mostly abnormal embryos, but based on the stats, that's average.

[Anonymous]

Talk to your doctor. Do the risks increase as you get older? Sure. But 35 is not some magical number where you’re guaranteed to have a child with chromosomal issues from then on out. Honestly, it’s more likely you’d have a higher risk of having a first trimester miscarriage due to chromosomal abnormalities. As other posters have pointed out, women have been having babies well into their 40s for a very long time. This isn’t new. What’s new is a woman having her first baby at 43, rather than her seventh. But this wouldn’t impact what you’re concerned about. Talk to your doctor and make an informed decision, but I wouldn’t be scared or spend too much time worrying.

[Anonymous]

Anonymous wrote:I was 36 when I had a Down syndrome pregnancy. It was a devastating diagnosis to get, but after doing some research and speaking with a genetics counselor, we decided to continue the pregnancy. My husband and I were both 37 when the baby was born. Although our son is delayed and we have a lot of medical appointments and therapies, I don't regret our decision to have him. He is a happy little boy who has brought so much joy to our lives. Yes, I worry about his future, but we have legal and financial arrangements in place that will hopefully allow him to lead a comfortable life after we're gone without becoming a burden to his brother.

However, the issue isn't whether you want your child to have a disability (no one does) or whether you could handle a disability if one happened (you could), but different levels of risk tolerance between you and your husband. You are very unlikely to be in the same situation as me (less than 1%), but it's not impossible. If you decide to proceed with trying for another child, you and your husband need to have a discussion about worse-case scenarios and how you would handle them. If you can't agree, then the answer is no, unfortunately.

I have more concerns about what happens after I pass. A distant relative of my family had their down syndrome child in a group home and that's where he died. No one in the family ever visited him. Since I can't control how mean other people can be, I wouldn't wish that on my worst enemy much less my child.