Aishwarya Rai is pregnant - time to celebrate and yet be careful.

The pitfalls and precautions in an elderly pregnancy

Aishwarya Rai was born on 1st November 1973 and is about 38 years old now. As reported, she is pregnant. Everyone wants to know about her pregnancy outcome. We wish her well and pray that the outcome is a healthy mother and child.

Now more and more working women are choosing to become pregnant at a later age. This comes with its own set of medical challenges and we take this opportunity to address specific issues related to the older gravid or women ≥35 years of age at the estimated date of delivery.

There is higher risk of fetal aneuploidy (trisomy 21, 13, 18). Aneuploidy is the condition of having less than or more than the normal diploid number of chromosomes. To diagnose aneuploidy, one may be advised to undergo invasive amniocentesis or chorionic villus test. The other alternative is to screen using maternal serum testing and ultrasound evaluation of fetal nuchal translucency to adjust the mother's age-related risk.

There is higher prevalence of Down syndrome in offspring of older women. One may ask for the screening for Down syndrome.

Age and obesity are risk factors for development of type 2 diabetes mellitus, as well as gestational diabetes.

There is an increased risk of congenital anomalies in older women and hence, a detailed second trimester ultrasound examination may be required to look for significant structural anomalies, especially cardiac anomalies.

Many pregnancy complications occur with increased frequency in older gravidae and they are spontaneous abortion, low lying placenta, pregnancy-induced diabetes, pre eclampsia, pre term birth and cesarean delivery.

There are also more chances of preterm delivery, low birth weight, intrauterine growth restriction, and stillbirths.

Most pregnancies at age 37 will need to be delivered at 39 weeks of gestation on medical grounds.

Chances of IVF pregnancy at this age are higher and hence a twin or a triplet delivery is likely.