From Our 2012 Archives
Pregnancy After 40: Healthy Weight Improves Risk
Age, Obesity Both Affect Risks, but Losing Weight Before Conceiving May Help, Experts Say
By Kathleen Doheny
Reviewed by Louise Chang, MD
May 9, 2012 -- Pregnancy after 40 does carry more risks, but being at a healthy weight before getting pregnant seems to modify those risks, new research suggests.
"If you are healthy, over 40, and not obese, your risks of pregnancy complications are certainly less than an obese 40-year-old," says researcher John R. Barton, MD, director of maternal-fetal medicine at Central Baptist Hospital in Lexington, Ky. "And [they are] not that much different, other than a higher C-section rate, than a non-obese, younger woman."
He compared obese and non-obese pregnant women in his study. Some were in their 20s. Others were in their 40s.
Obese older women had more complications than older women at healthy weights, he found. Barton presented the findings this week at the annual meeting of the American College of Obstetricians and Gynecologists in San Diego.
While birth rates in younger women have been declining, pregnancy after 40 is on the rise, according to the CDC. From 2008 to 2009, the birth rate for women ages 40 to 44 increased by 3%, to 10.1 births per 1,000 women. That is the highest reported since 1967 for that age bracket.
Pregnancy After 40: Study Details
Barton looked at data on more than 53,000 women. They were enrolled in a pregnancy risk assessment and education program conducted by Alere, a health management and diagnosis company, between July 2006 and August 2011.
Of that total, 1,231 were 40 or older. Of those, 228 were obese.
A body mass index of 25-29.9 is considered overweight. A BMI of 30 or higher is considered obese.
Barton looked at four groups:
Pregnancy After 40: Perspective
Some of the differences are not surprising, says Suzanne Lubarsky, MD, a maternal-fetal medicine specialist at Kaiser Permanente Northwest in Portland, Ore. She reviewed the findings for WebMD.
"The diabetes part isn't surprising, because we know older women who are obese are going to have the highest rate," she tells WebMD.
The difference in the premature delivery rate was somewhat surprising, she says. "The C-section rate was somewhat surprising, although we know obesity is a risk factor for C-section."
The new data will provide much added support for advice that Lubarsky says she already gives to women 40-plus hoping to become pregnant. "Being at their ideal body weight [before pregnancy] optimizes their pregnancy and reduces their risks and the risks to their babies," she says.
Barton reports receiving research grants from Alere San Diego and Beckman Coulter Inc. Both grants are for the study of tests for preeclampsia.
These findings were presented at a medical conference. They should be considered preliminary as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.
SOURCES: American College of Obstetricians and Gynecologists Annual Clinical Meeting, May 5-9, 2012, San Diego. John R. Barton, MD, director of maternal-fetal medicine, Central Baptist Hospital, Lexington, Ky. Suzanne Lubarsky, MD, maternal-fetal medicine specialist, Kaiser Permanente Northwest, Portland, Ore.
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