Sources of Birth Defects in Older Mothers Essay

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High-Risk Pregnancies



Having a baby is a dream that many families have. Women in particular are associated with the idea and "dream" of having a child but men are pretty excited about it to when it comes, albeit also nervous. However, there is a danger when it comes to waiting too long before starting a family in terms of age. Whether it is career concerns, finding the right, the delaying of the marriage or what have you, there are multiple reasons that are common in today's society whereby women put off having families. An unfortunate byproduct of this pattern is that the risk of birth defects is much higher with children born of women over the age of 35. This report shall explore the precise and specific reasons that these birth defects why it is more common for women beyond the line stated in this proposal. Even with the increasing propensity of women to have women at older and older ages, the problems that arise beyond a certain age for women is without question and it is statistically consistent. While women should absolutely have the freedom to have children if they desire them and have the resources, doing so beyond the age of 35 has risks that are common and inherent and the precise causes and potential results need to be explored.

Literature Review



There are so many directions that one could go with the brief literature review that underpins this proposal. However, the author of this proposal will go in directions that are perhaps less traveled and well-known to people that are familiar with this subject. Indeed, one source reveals that even with the higher propensity of fetuses to end up with birth defects when it comes to women that are older than 35, there are many women in that age group that actively avoid or at least procrastinate when it comes to taking those tests. While some women are averse to abortion as a means to avoid giving birth to a special needs child, it is something that women should choose with informed consent. However, many women avoid or delay this proper due diligence and this is not a new phenomenon. While general risk assessments and non-invasive screening can be useful, there are some other methods that are much more exhaustive and effective (Dunn, 2003).



Another dimension that truly exists but is not commonly looked at is who precisely to target when it comes to the screening for birth defects. Rather than simply cast a wide net and try to get as many people as possible with no specificity other than perhaps age, there are many that say that certain groups and cultures should get more scrutiny than others (Zhu et al., 2016). One last potential cause that can be mentioned has come to the surface when it comes to the recent Zika virus outbreak. Indeed, it has been found that there are extremely high and nasty risks of birth defects when it comes to women of any age that become infected with Zika. Why it is probably unlikely that other and more common viruses like influenza and the common cold are causing these sort of defects, the effects of bacterial and viral infections on women who are pregnant and their fetuses should probably get a higher amount of scrutiny based on what Zika is doing to many fetuses.



Even with 35 years old being a "line" that women should be careful about crossing, going older than 40 years of age before having children would seem to be even worse. Beyond that, having a multiple-birth pregnancy (e.g. twins) after the age of 40 is a huge risk. Of course, most women do not strive for multiple births in the same pregnancy. However, in vitro and other fertility treatments and methods are often done with a little excess so as to ensure a higher success rate. As such, it is not the least bit uncommon for multiple births to occur as a result.

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If and when that does happen, the perinatal risks that are involved are hard to miss or avoid. This is true even in the best of circumstances. However, underlying and chronic health conditions such as hypertension and diabetes, just to name two, up the proverbial ante even more (Grabowska et al., 2012).



While not completely in line with the angle that this report is taking, there are indeed women over the age of 35 (and beyond) that end up getting pregnant in an unexpected fashion. Even if the birth (or at least the pregnancy) was not intended, the results when it comes to mortality, economic and health statistics will still be affected. By default, the amount of prenatal care and such would be lower until the pregnancy is actually discovered and that could easily take a few weeks as compared to someone that is vigilantly keeping tabs on their ovulation and pregnancy status. To put it concisely, women of any age getting pregnant in an unplanned or otherwise haphazard fashion from a health and prevention standpoint are going to tend to skew the overall dataset. As such, that needs to be part of the consideration when it comes to how and whether birth defects are caught, when they are caught and what could/should/would be done about them when detected. Although the data was taken more than a generation ago, the mortality rate for women with unexpected pregnancies was triple the average (Darbois & Boulanger, 1990).



Even with the common narrative and message that is shared about women over 35 or 40 having kids, there are some people that clearly disagree and this includes when it comes to birth defects and other complications. Even more intriguing is that one of the sources that has proclaimed this was written nearly thirty years ago. Indeed, a journal article written in 1987 tried to assert that pregnancies over 40 are no long "high risk" (Darbois et al., 1987). However, the knowledge gained and learned since then has really proven all of this to be less than true. Just one example are the complications rendered from a study that ran from 2010 to 2014 that looked at something as simple as a flu vaccine. Just a few of the bad endings or complications that are mentioned are birth defects (in general), spontaneous abortion, pre-term delivery, babies that are on the small side given their gestational age and beyond. The presence of a vaccine or some other aggravating agent (from a childbirth perspective) is that there are clear differences in defect and negative event rates from adding (or removing) the vaccine by itself (Chambers et al., 2016). This is just one example of how a seemingly minor and basic thing. Similarly, it is commonplace for people to get a "Tdap" vaccine before the arrival of a baby. This is a cocktail vaccine that includes protection for tetanus, pertussis (whooping cough) and diphtheria. However, women that intend to get pregnant really need to get that shot out of the way and through their system before they get pregnant rather than waiting until after they have become pregnant. Not unlike the just-mentioned flu vaccine, the risk of birth defects rises a great deal if the timing of the vaccine is handled poorly and without forethought. While the presence of vaccines or other aggravating factors is technically not age-specific, the realized risks and problems that arise with these substances and events is amplified when speaking of older women having children. Much like anti-depressants/SSRI's amplify the effect of alcohol's effects on the body, the same thing happens with the risk of birth defects and aggravating events that lead to the same (Desilva, 2016).



One potential "boogeyman" out there when it comes to birth defects are environmental causes that are not known about. It is the opposite of what….....

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References


Chambers, C. D., Johnson, D. L., Xu, R., Luo, Y. J., Louik, C., Mitchell, A. A., & Jones, K. L.

(2016). Safety of the 2010-11, 2011-12, 2012-13, and 2013-14 seasonal influenza

vaccines in pregnancy: Birth defects, spontaneous abortion, preterm delivery, and small

for gestational age infants, a study from the cohort arm of VAMPSS. Vaccine, 34(37),

4443-4449. doi:10.1016/j.vaccine.2016.06.054

Darbois, Y., & Boulanger, M. C. (1990). [Are unexpected pregnancy over age 40 at high

risk?]. Revue Franccaise De Gyneacologie Et D'obsteatrique, 85(3), 158-160.

Darbois, Y., Lefebvre, G., Vauthier, D., & Camus, M. (1987). [Pregnancy over the age of 40 is

no longer a high-risk pregnancy]. La Revue Du Praticien, 37(9), 481-487.

DeSilva, M., Vazquez-Benitez, G., Nordin, J. D., Lipkind, H. S., Romitti, P. A., Destefano, F., &

Kharbanda, E. O. (2016). Tdap Vaccination During Pregnancy and Microcephaly and Other Structural Birth Defects in Offspring. Jama, 316(17), 1823-1825.

doi:10.1001/jama.2016.14432

Dunn, A. (2003, March 13). Older women avoid birth defect tests. Age, The (Melbourne). p. 6.

Grabowska, K., Metcalfe, A., Pastuck, M., Tough, S., & Johnson, J. (2012). OP30.01: The

perinatal risks of twin pregnancy in women over the age of 40. Ultrasound In Obstetrics

& Gynecology, 40145-146. doi:10.1002/uog.11680

Oakley, G. J. (2012). Failing to prevent birth defects caused by maternal diabetes

mellitus. American Journal Of Obstetrics And Gynecology, 206(3), 179-180.

doi:10.1016/j.ajog.2011.12.019

Rasmussen, S. A., Jamieson, D. J., Honein, M. A., & Petersen, L. R. (2016). Zika Virus and Birth Defects -- Reviewing the Evidence for Causality. The New England Journal Of

Medicine, 374(20), 1981-1987. doi:10.1056/NEJMsr1604338

Tanner, J. P., Salemi, J. L., Stuart, A. L., Yu, H., Jordan, M. M., Duclos, C., &... Kirby, R. S.

(2015). Associations between exposure to ambient benzene and PM2.5 during pregnancy

and the risk of selected birth defects in offspring. Environmental Research, 142345-353.

doi:10.1016/j.envres.2015.07.006

Yau, W., Mitchell, A. A., Lin, K. J., Werler, M. M., & Hernandez-Diaz, S. (2013). Use of Decongestants During Pregnancy and the Risk of Birth Defects. American Journal Of

Epidemiology, 178(2), 198-208.

Zhu, Z., Cheng, Y., Yang, W., Li, D., Yang, X., Liu, D., &... Zeng, L. (2016). Who Should Be

Targeted for the Prevention of Birth Defects? A Latent Class Analysis Based on a Large,

Population-Based, Cross-Sectional Study in Shaanxi Province, Western China. Plos

ONE, 11(5), 1-16. doi:10.1371/journal.pone.0155587

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