What are the risks of having a baby?

A 39-year-old big S gave birth to a second eclampsia and was admitted to the intensive care unit. 40-year-old Bidai Syulan is pregnant and needs to stay in bed 142 days. The 35-year-old Weifang woman had to leave a gauze strip on her abdomen because of postpartum hemorrhage caused by placenta implantation ... These online news made many elderly expectant mothers shudder. The older she gets, does it really mean the greater the risk? If so, how to avoid it?

Please welcome big doctor in this issue. We specially invite chief physician Yu Song from Beijing Huafu Women and Children's Hospital to talk about the problems that the elderly and high-risk women should pay attention to in the process of pregnancy preparation, pregnancy, delivery and postpartum recovery.

Q: Is it really risky to have children when you are old? Old age = high risk?

Yes, pregnant women over the age of 35, whether pregnant women or fetuses, will have significantly increased risks in all aspects, that is, "high risk." In clinical work, for women over 35 years old, we all carry out clinical management according to "high risk".

The concept of high risk is very big, and there are many influencing factors, such as maternal age, previous delivery, overweight/obesity, complications and so on. Old age is the inducement of high risk. In other words, as long as they are over 35 years old, they can be classified as high-risk pregnant women.

Q: Is the risk of having a first child after the age of 35 the same as that of having a second child?

The best time for female ovarian function should be 17- 18 years old. After the age of 30, it will gradually decline, including the secretion of estrogen and the quality of eggs. Therefore, in medicine, over 35 years old is regarded as a sign of elderly pregnant women.

First-born children over 35 years old, that is, primiparas, have high-risk factors such as old age, which will have adverse effects on both mothers and babies; After all, a multipara who has a second child over the age of 35 has been pregnant and given birth, and its risk will be much smaller than that of a primipara.

Q: I don't want to have children too early. When I was "young", I tried to stay healthy and take care of myself. Is it too old to be over 35?

That's not true.

Being old or not mainly depends on ovarian function, which is independent of human will. As I said just now, in fact, the ovarian function of women over 30 years old has begun to decline. Of course, this is only the trend of the vast majority of people, and there are still individual differences between people.

Q: In order to avoid the risks of pregnancy and childbirth, what preparations should elderly women make before pregnancy?

In fact, many people are pregnant without preparation. However, from the perspective of safety, we suggest that couples who intend to have children have a comprehensive physical examination before pregnancy, including endocrine, ultrasound, reproductive system, male semen examination and so on. , and consult relevant experts.

Especially for women who are older, have a bad pregnancy history (such as abortion and dystocia) or have complications such as hypertension, diabetes and thyroid disease before pregnancy, and take medicine for a long time, the consultation content includes whether it is suitable for pregnancy, the best pregnancy time and what problems should be paid attention to during pregnancy.

Q: I just got pregnant and I don't know. I accidentally drank wine and took cold medicine. Can this child have it?

First of all, both mom and dad must give up the bad habit of smoking and drinking before pregnancy. Nicotine in tobacco can cause vasospasm, reduce the blood volume of uterus and placenta, and lead to chronic ischemia and hypoxia and developmental retardation of intrauterine fetus. Long-term heavy drinking before and during pregnancy may lead to various fetal malformations, and male alcoholism may also affect sperm quality.

Whether drinking and taking medicine will affect children without knowing pregnancy depends on whether bad factors appear in the critical period of fetal development. Generally, 3- 10 weeks after conception is the most critical period for the development of fetal heart, nerves and organs, and it is also the most susceptible to external factors. During this period, taking medicine and contacting with physical, chemical, biological and other harmful substances may lead to fetal malformation.

As for drinking, it's not a problem to drink occasionally. If it is alcoholism and it happens to be in the critical period of children's development, we may suggest giving up.

For pregnant women who have a bad "exposure history" before and insist on continuing pregnancy, it is strongly recommended to have strict prenatal examination during pregnancy, including nt (transparent layer of fetal neck) examination at 1 1- 13+6 weeks, large teratogenic system screening, and prenatal diagnosis if necessary, such as amniocentesis.

Q: Does amniocentesis stick a needle into the stomach? I heard that it will lead to miscarriage? Are there any other options?

Amniocentesis is a means of prenatal diagnosis, the main purpose of which is to confirm whether the intrauterine fetus is healthy and whether there are chromosomal abnormalities and body surface abnormalities, which is especially important for elderly pregnant women.

However, amniocentesis is a kind of traumatic examination, which has certain risks for both pregnant women and fetuses, and may cause maternal infection and local hematoma, and even the probability of abortion is 0.5%- 1%.

So there may be many pregnant women who are unwilling to do amniocentesis. For these people and pregnant women who have had repeated abortions and unhealthy babies, we advocate non-invasive DNA testing first.

However, it should be noted that non-invasive DNA can only be used for prenatal screening, not for diagnosis. Although the accuracy is very high, it can only be used to detect trisomy 2 1, 18 and 13 syndrome, and cannot diagnose other chromosome number and structural abnormalities. Amniocentesis can not only find abnormal chromosome number, but also find local balanced translocation, deletion and inversion.

Q: It is said that children who give birth naturally are smarter. Can elderly women give birth naturally? The first child was cut, can the second child be successful?

Generally speaking, if there are indications of cesarean section such as abnormal bone birth canal or soft birth canal, medical complications or pregnancy complications, or intrauterine hypoxia, intrauterine distress, umbilical cord or placenta problems, cesarean section is necessary. Sticking to natural delivery is very risky for both mother and fetus.

In addition, our obstetricians strongly recommend that pregnant women give birth naturally, and so do elderly women. For mothers, the amount of bleeding caused by caesarean section and the risk brought by the operation itself are far higher than those caused by vaginal delivery. In the long run, it also involves many problems of contraception and re-pregnancy. For children, the extrusion of the birth canal is beneficial to the development of various systems including the immune system in the future.

The time interval between two caesarean sections should be more than 18 months. The first child is a caesarean section. If the second child does not need a caesarean section, it can be delivered naturally, and the success rate of natural delivery is as high as 75%.

Q: In order to make the baby healthier, can I make it up when I am pregnant?

You can't. As mentioned earlier, being overweight or obese is also a high risk factor. In fact, pregnant women with a body mass index over 25 may suffer from chronic diseases such as hypertension, diabetes and hyperlipidemia due to overweight and obesity, which greatly increases the risk of accidents and adverse outcomes during pregnancy.

Generally, expectant mothers with moderate weight should gain weight10-1kg during pregnancy, and if they are thin, they should gain weight 12.5 kg. For overweight and obese women, weight gain during pregnancy should not exceed 5-7 kg.

Excessive weight gain during pregnancy means that pregnant women are more likely to suffer from pregnancy complications such as gestational diabetes and pregnancy-induced hypertension, which will bring adverse consequences to the mother and the baby.

Q: When I grow up, I will have a child. What should I eat if I am pregnant?

Older parents-to-be should have a comprehensive pre-pregnancy examination and a balanced diet when preparing for pregnancy. There is no need to take a lot of health care products after three meals, which will not only have no effect, but also increase the burden on the liver and produce adverse reactions.

After a real pregnancy, we suggest that expectant mothers should supplement iron, calcium and folic acid appropriately under the guidance of doctors, especially those who are anemic or partial eclipse before and during pregnancy.

Q: Will the health and intellectual development of babies born to elderly women be affected?

If the mother can complete all kinds of examinations regularly and comprehensively, the child will have no birth defects, which can completely guarantee the child's health and intelligence.

Q: Will the postpartum recovery of elderly women be slower?

Pregnancy and childbirth affect all systems of women, and it takes at least 6 weeks for non-elderly high-risk women to fully recover. Older women's ovarian status and uterine status are not as good as those of ordinary women, and their recovery will be slower.