AN “EPIDEMIC of middle-aged pregnancy” threatens the health of mothers and babies as a growing number of women delay having children to pursue their careers.

An editorial today in the British Medical Journal gives warning of the risks run by women who wait until their mid-thirties before trying for children. It refers to the growing number of cases of age-related fertility problems and other health complications.

The authors, all obstetricians and gynaecologists, said that the “have it all” generation of women who go for careers first, then try for children, were defying the natural progression of their biological clocks. They said that many seemed unaware that they could miss out on motherhood altogether.

It is widely accepted that the best time for having a baby is between the ages of 20 and 35, with fertility problems increasing after 35, and dramatically so for women over 40. Once a woman in this age group is pregnant, the outcomes for mother and child are worse.

According to the Office for National Statistics, over-35s now have the fastest-growing birthrates. Women having babies in their 40s have nearly doubled in ten years. The number in their 30s is up by two thirds and now outstrips those in their 20s.

High-profile examples of late motherhood include Madonna, who had her last child at 42, Liz Hurley (36), the actress Emma Thompson (40) and Cherie Blair, who gave birth to Leo in 2000 at the age of 45.

Susan Bewley, a consultant obstetrician in maternal-foetal medicine at St Thomas’ Hospital in London, said that many career women appeared unaware that they were gambling with their ability to reproduce. Dr Bewley said that she and her colleagues were witnessing the problems of the growing number of middle-aged pregnancies first-hand.

“Delaying having children is like Russian roulette,” Dr Bewley told The Times. “If you win you feel clever, but if you don’t you will regret it.”

She said that other factors, such as increasing life expectancy, less rigid attitudes to retirement and longer spent in education were giving people the false impression that everything in life could be delayed.

“The problem is that women who want to be mothers are now drifting out of the normal physiological range. As the population as a whole drifts, we must stop and examine the repercussions.” Dr Bewley and her fellow authors, Melanie Davies, a consultant obstetrician and gynaecologist at University College Hospital, London, and Professor Peter Braude, head of women’s health at Guy’s, King’s and St Thomas’ School of Medicine, write of the many age-related problems that can hinder conception and cause ill-health for mother and child.

“Most pregnancies in women older than 35 have good outcomes, but small shifts in population distribution curves affect large numbers of women. Obstetricians and gynaecologists have seen dramatic changes in two decades alongside this demographic transformation and are witnesses to the resultant tragedies.”

Problems cited include infertility, higher rates of miscarriage, ectopic pregnancies, foetal and chromosomal abnormalities and the increased likelihood of a premature birth, stillbirth or neonatal death.

There is also a greater risk of pregnancy diseases such as pre-eclampsia, which causes abnormally high blood pressure, during the second half of pregnancy, posing dangers to both mother and child.

“If you delay having children for ten years, that is ten more years to collect up medical disorders and diagnoses, such as high blood pressure or rheumatoid arthritis,” Dr Bewley said.

The authors suggest that factors at birth, such as low birthweight, could trigger later health problems for a baby, such as diabetes. Delaying also affects partners and children of older men have an increased risk of schizophrenia and genetic disorders.

The authors call on doctors to help women to achieve “biologically optimal childbearing” and question why public health agencies target teenagers but ignore the issue of later pregnancies.

COMPLICATIONS

Children of older fathers may suffer from schizophrenia and genetic disorders

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