Perils of Pregnancy: Obesity and Advanced Age

 

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Hypertensive disorder, chronic hypertension and preeclampsia can result in placental insufficiency, which in turn can lead to smaller babies and decreased fetal growth. If the placenta cannot keep up with the growth needs, the fetus is smaller and has a higher incidence of cardiovascular problems.

In diabetes, out-of-control glucose can lead to other fetal anomalies. High maternal blood sugar later in pregnancy can cause the fetus to grow too big. Glucose can be toxic to the fetus, and if blood sugar is high in the first trimester the fetus is at higher risk for cardiac or neural defects or skeletal problems.

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Advanced Maternal Age

Though older women are at increased risk for hypertension and diabetes in pregnancy, most who are healthy will have no problems.

Much of the data on older women depends on socio-economics, and poorer women have poorer outcomes, according to Wenstrom.

Pregnancy can, however, serve as a "stress test" for what a woman might develop later on in life. Those who have preeclampsia tend to develop heart disease and hypertension. Those with gestational diabetes may get "full-on" diabetes, she said.

"If a woman is in good physical shape and doesn't smoke, age is not a factor," said Wenstrom. "A lot of the older literature suggests they were at increased risk -- in the days when they were 40 and smoking. Those were older women like Bette Davis. But that was then. Now they are like Madonna and it's a different era. They take care of themselves."