[Pregnancy and delivery in women above the age of 35]

During the past decades there is a tendency among women in developed countries for postponing their reproductive plans for later age. This results from the substantial change of women's role in society and the development and availability of assisted reproduction technologies. The latter made possible women to become pregnant after the end of their reproductive years. In the present review, data from the literature, published in the recent 15 years and related to pregnancy course and outcome in women above the age of 35, are analyzed. Decreased fertility, higher incidence of early pregnancy complications including spontaneous abortions and ectopic pregnancy, and of congenital anomalies (chromosomal, structural, genetic syndromes) are discussed. Advanced maternal age is characterized with more frequent late pregnancy complication such as hypertension and diabetes. Problems of placentation, perinatal and maternal mortality are more frequent in these patients.. Data at present suggest higher risk for maternal and fetal pregnancy complications as maternal age advances. On the other hand, some positive aspects of postponing pregnancy have to be considered--financial, emotional, and the overall low absolute number of complications. With adequate antenatal care it is possible for women of advanced maternal age to have successful pregnancies with overall favorable outcome comparable to that in young women.