Nutrition and the older primigravida

The numbers of older primigravidas, women pregnant for the first time at age 35 or later, are increasing. The main potential complication of such pregnancies is an increased incidence of pre-gravid essential hypertension. Published materials on hypertension in pregnancy emphasize control by antihypertensive drugs. Dietary recommendations for the hypertensive pregnant woman are identical with those for the normotensive gravida. A higher incidence of overweight at the time of conception might be predicted among older women. Because weight control reduces both blood pressure and obstetrical risk, there are implications for preventive nutrition counseling among nonpregnant women of childbearing years. Declining metabolic rate with age may dictate a slightly decreased caloric need among older primigravidas. Dietitians, nurses, nutritionists, physicians, and other members of the health care team should be aware of the societal trend toward postponed childbearing. Weight control and monitoring of the blood pressure of nonpregnant women of childbearing years might be emphasized as preventive measures to reduce possible complications when and if the women become pregnant. Such information might be incorporated into health screening, fitness, nutrition education, or weight control programs or be provided as part of a care plan following nutritional assessment. Support groups for women might include such information in their programs. Special nutritional needs of the older primipara should be considered by dietitians, nutritionists, nurses, nurse-midwives, obstetricians, and other health care personnel.