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Delayed pregnancy not good for child’s health

By Satyen Mohapatra

Dec 5, 2018

New Delhi:“ In no way is it nice to have a late pregnancy” says Dr Jaideep Malhotra, president, The Federation of Obstetric and Gynecological Societies of India.
In an interview she said, “There are plenty of studies to show that after 30-35 years of age a woman’s health status and egg reserve goes down. A woman is born only with a set number of eggs which gets depleted over time. Besides diabetes, obesity, hypertension, cardio vascular diseases are on the rise and start manifesting early even in late 30s.”

As the foundation of the child’s health and proneness for disease is laid in the womb of the mother itself, a woman with diabetes, hypertension, cardio vascular disease, stress, pre disposes the yet to be born child for these diseases, she added.
Delayed pregnancies also lead to a lot of pre mature babies. Today nearly 27 per cent babies are born pre mature, Dr Malhotra said.

“Even though there is no ideal age for pregnancy but 25-26 should be an age when one can plan for being a mother. Ideally during the time span of 25-35 years, you should have completed your family because chances of pregnancy itself reduce with age.”

Secondly chances of having a healthy pregnancy, she said, also go down with age as older women are prone to have more miscarriages and other complications.

“Don’t blame the women for wanting late marriage and pregnancy because women need to be empowered both by good education and a good job. It’s a constant battle in the mind of a woman as to what to do and what not to do? Family has to go hand in hand with job and career for most.”

Dr Malhotra said, eighty percent women conceive within one year if they are having sex without using contraception.

“Even though there have been many breakthroughs and sophisticated, scientific technologies have been developed to assist a couple to have a child at whatever age they want, the natural process is the most healthy, least risky and the best,” Dr Malhotra added.

Even IVF does not have a 100 per cent success rate but only around 60 per cent per cycle. Looking at the present social conditions a company like Apple is ready to pay for the women employees egg preservation so that the woman employee will have the choice of having the child when she wants.

However ,there are ICMR guidelines that women above 45 are not to be offered IVF option, Dr Malhotra informed.
Dr.Rishma Pai, consultant Gynaecologist at Jaslok and Lilavati hospitals in Mumbai and also immediate past president of the Federation of Obstetric and Gynecological Societies of India., said,“ Planning to have a child is not a priority for young newly wed couples today”.

Though 25-35 years is an ideal age bracket to become pregnant, couples delay it as they feel their professional life , travel life, all are likely to be hampered with the coming of a child.

“They would like to go whenever and wherever they feel like and therefore are not ready to take on the responsibility or burden of a child till quite late”, she added.

The young couples of today are “self focused” and work single mindedly towards personal success and advancement.
She said, “After 35 pregnancy become tough and it is more difficult to conceive .Woman’s ovarian reserve is declining , with the number of eggs rapidly going down as well as the quality of eggs deteriorating.”

Late pregnancies come up with many other problems like higher incidence of Down syndrome (which results in mental and physical abnormalities) and high risk of the baby having proneness to diabetes and blood pressure because the onset of these diseases have started in the mother.

Dr Pai said, “Many women who are getting married late today are getting their eggs frozen and preserved at a much earlier date so that they can use them at whatever time they want to conceive after marriage. The frozen eggs do not age and the woman gets a young egg for conception even though she is old.”

Dr. Urvashi Sehgal , famous for pioneering water birthing in India and Joint Director at Phoenix Hospital, New Delhi, said,“ The decision to have a baby and when to have a baby are strictly individual and is are purely personal choices. Some couples decide not to have babies at all. But couples must know and be clear about what they want and take all right steps to fulfill their decision”.

A recipient of the President’s Gold Medal (MBBS) as well as the ‘Distinguished Service Award’ from Indian Medical Association , Dr Sehgal said, “Couples when delaying pregnancy must understand what they are doing to avoid any complications and frustrations later.”

“ The older one gets both the the egg quality and sperm quality deteriorates and the likelihood of complicated cases increase,” she added.

Dr Helai Gupta, Senior Consultant Obstetrics and Gynecology Apollo Cradle and Spring Meadows Hospital,Delhi, said that the trend of delayed marriage and postponement of pregnancy was a phenomenon primarily confined to the urban, educated, working women.

These women are career oriented, she said, and want to be financially independent and professionally settled before getting married.

Dr Helai said there was unnecessary “alarm” regarding delayed marriage or late pregnancy because “your age is not the only contributory factor in determining the outcome of pregnancy”

It is critical, she said, for a pregnant woman to have access to good health care and good neo natal care. An older woman settled in her career with sound financial backing can fulfill these needs more than a young struggling student stressed out with pregnancy without adequate financial support.”

A relaxed mental status of the woman also contributes to the outcome of pregnancy, she added.
Dr Gupta said, “As far as body fitness level is concerned a 20 year old woman of yesteryears is comparable to that of a 30 year old woman today. Secondly availability of sophisticated technologies to detect genetic abnormalities, malformations, Down’s syndrome, virtually rule out any risk to the baby and the mother in today’s world even if she is old.”

“A woman can decide to safely have a baby till she is 40-42 years,” Dr Gupta added.
Dr Abha Majumdar Director IVF at Sir Ganga Ram Hospital said, “Best age to get pregnant is early 20s, but one can have babies between 23 – 35 years. After 35 ovarian reserve starts reducing in India due to genetic status and socio-economic status whereas the in the west it starts reducing around 37”.

As your age advances your reproductive potential goes down,midlife diseases like endometriosis,fibroids, chromosomal abnormalities are likely to occur.

Dr Sodhi, Senior Consultant Obstetrics and Gynecology at Moolchand Medcity Hospital, Delhi, said that late pregnancies can result in hypertension and diabetes being precipitated early and there are chances of fetal malformations due to chromosomal defects.
Between 25 to 32 may be the right age for becoming a mother because after 35 all these problems crop up, she added.

(India News Stream)