Women are overall waiting longer to have children, often while they pursue education and careers. According to an article in the New England Journal of Medicine, the number of first births for women age 35 to 39 increased by 36 percent between 1991 and 2001, and the rate among women age 40 to 44 grew by 70 percent.
Medically, women who have children at age 35 or older are considered to be of advanced maternal age, even though 20% of all women have their first child at age 35 or after. There are six pregnancy-related risk factors associated with advanced maternal age: decreased fertility, miscarriage, genetic problems, high blood pressure, stillbirth, and maternal death.
Advanced maternal age can lead to an increased risk of birth injury. Contact The Becker Law Firm at 216-621-3000 for a free consultation with one of our Ohio birth injury lawyers today.
Risks Associated with Advanced Maternal Age
With an increase in maternal age comes an increase in the risk of many birth injuries and birth defects, including:
- Down syndrome, neural tube defects, and other birth defects
- Miscarriage
- Gestational diabetes
- High blood pressure
- Placental problems
- Premature birth
Physicians must inform older women of the potential risks so they can make informed decisions about their pregnancies. Obstetrical caregivers must also carefully manage these risks in order to prevent possible injuries to the mother and child.
The Ohio birth injury lawyers at The Becker Law Firm represent families who have been harmed by medical negligence, including failure to recognize potential issues associated with advanced maternal age and failure to make a referral to a doctor who specializes in high-risk pregnancies, such as a perinatologist or a maternal-fetal medicine (MFM) specialist.
Down Syndrome and Advanced Maternal Age
Advanced maternal age is directly related to an increased risk of Down syndrome.
According to the American Academy of Family Physicians, the risk of having a child with Down syndrome is:
- At age 25: 1/1,300
- At age 35: 1/365
- At age 45: 1/30
Testing can detect the presence of chromosomal defects that cause Down syndrome and other birth defects. Parents must be offered the opportunity to find out whether their child has these defects. The testing is voluntary; presenting the opportunity to be tested is not.
Physicians who fail to offer parents these tests can be held legally responsible in a wrongful birth lawsuit should the child be born with Down syndrome or another birth defect.
Declining Fertility: Negligent Fertility Treatments and Miscarriage
Statistically, older women are less fertile. It is not an all-or-nothing degree of fertility like a light switch, but rather it is a sliding scale. Among each age group, compared to the prior age group, there are fewer pregnancies where birth control is not practiced.
This means that women aged 35 and older, as a group, have more difficulty becoming pregnant and delivering children. There are two major reasons why this increased difficulty is important for medical malpractice.
First, women over age 35 are more likely to undergo fertility treatments to overcome an inability to become pregnant. Those fertility treatments and the resulting pregnancies carry with them an increased risk that must be considered and monitored by doctors. Though the choice of in vitro fertilization has a four percent higher risk of genetic abnormalities, many problems are preventable.
Some of the negligent risks of fertility treatments include:
- Bleeding and death from egg retrieval procedures
- Implanting the wrong embryo, using the wrong sperm, or using the wrong eggs
- Failing to test donated products for sexually transmitted diseases
- Failure to perform proper genetic testing or health/age background checks on donors and donated biological materials, resulting in children born with genetic injuries
- Negligent destruction of viable embryos
Second, women aged 35 and older are more likely to have miscarriages. Miscarriage is a spontaneous abortion before 20 weeks. These risks are often caused by increased chromosomal abnormalities. In a small percentage of situations, doctors may be able to prevent miscarriage through medication and other interventions. Doctors must timely diagnose a miscarriage to prevent maternal harm—if not properly diagnosed a harmful and perhaps fatal infection could be the result.
Chromosomal Abnormalities, Hypertensive Complications, Stillbirth and Maternal Death
Advanced maternal age is widely recognized as increasing the risk for chromosomal abnormalities. These are genetic problems that can cause health problems for the baby, including Down syndrome, Tay-Sachs disease, cystic fibrosis, and others.
There is no cure for these conditions, however, doctors may have a responsibility to timely diagnose genetic defects. In many states, parents have a right to terminate the pregnancy because of genetic defects, when detected early enough. A doctor who fails to give expectant parents that option may be responsible for the extraordinary medical care that the child will require over his or her lifetime. Lawsuits of that nature are known as wrongful birth cases.
Increases in blood pressure (hypertension) can cause problems in pregnancy. Women aged 40 and older are both more likely to have higher pre-pregnancy hypertension and more likely to develop pregnancy-related hypertension. High blood pressure can cause premature delivery, which means that “older” women are more likely to deliver premature or low-birthweight babies. Doctors must take care to identify hypertension and to treat it during the pregnancy to ensure the baby’s health.
Also associated with advanced maternal age is stillbirth, the death of the baby after 20 weeks. Women aged 40+ are two-and-a-half times as likely to have a stillborn baby. Stillbirth is not common under either circumstance, but wrongful death of the baby is still a risk.
Finally, as women age, there is an increased risk of maternal death during pregnancy, labor, and delivery. Some studies have indicated that women 35 and older may be three times as likely to die because of pregnancy or childbirth, compared to younger mothers. Like stillbirth, however, maternal mortality is rare at any age.
