Prenatal medicine specialist responds: Pregnant over 40: What women (and others) should know

Prominent pregnant women over 40 often face emotional discussions, not just when it comes to celebrities like Jeanette Biedermann (46), who became a mother "late." Medically, the situation is more nuanced, according to Pränatalmediziner Prof. Karl Oliver Kagan. Age plays a role, but it's not the only factor, he explains. Women over 40 can have a child, but the risks increase with age.

However, it's crucial to consider this in a differentiated way. The majority of pregnancies are healthy, even for older women, he states. Prof. Kagan has personally treated many pregnant women in their 40s, and he means women over 45 as well. Not every increased risk becomes a problem. Today, the average age of delivery is around 31 to 32 years, and about five percent of pregnant women are over 40 at the time of conception.

This shows how much fertility has changed in recent years. Specifically, risks include fertility decline, chromosome disorders like Trisomie 21, higher rates of fetal abnormalities, and maternal complications such as gestational diabetes, hypertension, and placental insufficiency. The cesarean rate also increases. The situation is a continuum, not a switch that turns on or off at age 35 or 40.

Women who are over 40 and want to get pregnant should first address the topic and be open to more frequent monitoring. They should be oriented towards their individual risk profile for early detection of potential problems. For those interested in Trisomie 21, the non-invasive prenatal test (NIPT) is recommended instead of a traditional amniotic fluid test, as the latter is only useful if it has consequences for further management.

Ultimately, an older pregnant woman carries an increased risk profile, but it doesn't mean it won't work. It means that good information and good care are essential.