AIBU to worry about my sister’s pregnancy risks at 46?

her the glucose test for gestational diabetes and she’s refused it.

I had that as Dad was diabetic - so don't get why that test would be refused - it is a bit of a pain fasting and waiting round so is it a logistical issue?

I did know one mother she had 4 post 40 - and last but one she had gestational diabetes with - she blamed her diet - wasn't there for any previous 6 pg or last one.

Over 40 NHS apparently does like to offer - but maybe she look at her risk factors and decided not worth it - I assume her MW will have advised her.

Not wanting NIPT Down syndrome test - well is she is aware of risks and won't abort what ever not sure it would be helpful.

I've known mother's this old - most with no issues depsite may of them having had IVF which also increase some risks I belive.

I had people telling me they were worried about our choices round my pg - never helpful. She pg an adult and with access to medical care - your worrying changes nothing.

I have a friend with a large number of children who had her youngest at 47.

The pregnancy was no harder than her previous ones, although each one had been difficult in some way. She had gestational diabetes with the youngest 4 or 5 and pre term deliveries with all but her second.

The baby is now 5 & apart from a developmental delay, which three of his older siblings also have, he’s healthy.

Refusing the blood glucose test is unconscionable. Fair play if Downs wouldn't change her mind about keeping the baby, although I'd argue you'd do better to be prepared to deal with the other health issues it brings ahead of time (e.g. heart problems) so that you could actually care for them and keep them well... But refusing the blood glucose test is neglectful.

Glucose test - they will check her urine for sugar anyway so this refusal is not a great risk
NIPT - if she knows she wouldn't terminate then again, no issue here. She will have the 20 week scan which will check baby's heart etc so NIPT wouldn't really add much value here
Age - 46 is not 76, if she's overall healthy then she will be absolutely fine. Plenty of women give birth at this age and the main risk here is miscarriages rather than something happening to her

I had a natural pregnancy at 46. Absolutely no complications at all. Just put your 'worrying' energy into being supportive, because it's her body, her pregnancy and her medical choices.

A friend had her one and only at 47 with no problems. My 3x great grandmother had seven babies between 40 and 50. All were fine. I'm descended from the one born at 50.

I have a friend who was born when his mum was 46. He’s 40 and she’s a reasonably sprightly 86. He wasn't a surprise baby, she just desperately wanted another when all her
kids were grown! Anyway, I knew her very well, she’s lovely, he has always been healthy had a perfectly lovely upbringing.

I also have a friend who just had her 2nd at 44. She had an emergency c section,
but it went well - all parties are fine.

She’s a fool to refuse the glucose test. I had no symptoms whatsoever but was booked in and they discovered GD and it didn’t go away after my son was born I now have type 1 diabetes.
As for the other tests I had both children in my 40s and after the nuchal fold measurements were normal we declined any further tests. A relative got pregnant at 40 and did have an amniocentesis but it couldn’t pick up that her DD was profoundly autistic.
I do have a friend who had a surprise pregnancy at 46 and her son is now a healthy 23 year old!

I had DC2 (natural conception) at 45. I was offered the glucose/GD test purely due to my age - I took it but all was normal and had no complications in the pregnancy. DC2 arrived perfectly healthy. I can understand the worry, but it is her risk to take and it is more likely than not that all is fine. I've known mums who were 10 + years younger than me have children born with issues despite being low risk - it's always a gamble regardless of age. Best of luck to your sister, hope all goes well.

I had my third baby the week I turned 44. Everything went very well. Conceived naturally. I am healthy and on no medications, no smoking or alcohol etc.
I did not decline any tests at all, I attended all my NHS appointments, and had cons-led hospital delivery.
I hope all goes well for your sister. Have you offered to support her with going to appointments or exploring why declining glucose test ? Declining glucose test seems crazy to me. Unmanaged gestational diabetes is dangerous, it’s much safer to know if you have it and manage it.

My lovely aunt had 5 children, the last (and perfectly healthy) at age 46. Back in the old days it was common to keep conceiving until the body was finished.
So obviously that's not to say that nothing could go wrong, but it's really not as big of a deal as it sounds.
However, I'd certainly encourage her to do the routine medical tests such as gestational diabetes.

She's a grown adult who is capable of making her own informed decisions about her health.

Being pregnant doesn't make your health decisions open for public scrutiny and judgement.

She will likely have perfectly reasonable reasons why she has made these decisions. She is not obliged to justify them to you. It is not for you to judge her for doing it 'wrong'. There is no wrong here. There is a way that is right for her.

Basically butt out. It's none of your business.

I can understand refusing the NIPT but perhaps you could support her with the glucose test. Was it the glucose tolerance test or the routine urine dipping? I had the GTT when I was pregnant at 27 and didn’t have gestational diabetes it turned out. Is she worried about the practicalities of the test? Perhaps you could support her with this, the school run on the date or similar. So she feels more confident in going.

If she has conceived naturally, carried to 24 weeks and is well in herself, then the risk to her is little more than any other pregnant woman.

Th risk to the baby is slightly higher than with a younger mum, but if she eats healthily and takes her pregnancy vitamins there is a very good chance all will be OK.

i conceived naturally and had ds at 45y2m. I had a perfect pregnancy, no nausea, worked until 36 weeks. I knew when I was tired and had done enough, and I understand why she doesn't want fuss. I wasn't offered a test for diabetes either. I was checked for Down's though. But that is her decision. Credit her with knowing her own body.

Refusing the test for maternal pregnancy diabetes isn't suggesting that she'll love the baby whatever, it's only head in the sand. Diagnosing diabetes if present would massively increase chances of a live birth compared to undiagnosed maternal diabetes.

The OP's worry is understandable in this context. We all know worrying without doing anything constructive doesn't in itself achieve anything, but perhaps the glucose tolerance test and exactly what it is might be something to try to wangle into conversation - tricky, depending upon their relationship obviously. Unasked for advice usually just causes people to double down of course, but this could save the baby's life if she was developing pregnancy related diabetes.

I understand not testing for Downs, if it wouldn’t change her mind about continuing with the pregnancy, but having had gestational diabetes, I would say that it’s worth being tested for it. The test is a bit of a pain but one of the least unpleasant experiences of pregnancy. It’s so easy to treat too - but only if it’s diagnosed. I have had it on more than one occasion, but it was only diagnosed with one of my pregnancies. The difference in giving birth and in the overall health of the babies was marked.

Neither of those tests are standard in Northern Ireland. At least in 3 pregnancies I’ve never been offered either of them in the Belfast trust area. I think you’re only offered the test for gestational diabetes if you have a high BMI or close family history of diabetes. Does she have either of these risk factors?

I share only to say if she lived here I don’t think she would have even been offered these tests so declining them might not be a big issue?

I conceived naturally at 44 . Only downside was having to have a CS as my blood pressure was rising at the end . I did opt for amniocentesis though. My son is now a strapping 24 year old who has kept me young 😊

I didn't screen for down syndrome as I would have continued the pregnancy anyway. Her choice might not be what you'd do but it's still a valid choice.

The not engaging with health checks is worrying at any age to be fair.

Any pregnancy any age is a risk. Keep your concerns to yourself and just support her x

I didn’t say that there weren’t extra risks.

Doing a school run and getting to a hospital all whilst fasting and pregnant is hard (especially with the heat we’ve been having). I didn’t say it was invasive I said it was unpleasant.

I did and was perfectly fine. Child is now 14 and I am 60. I am fit and healthy and certainly not exhausted with older parenthood as we are told we will be.

I don't know why she wont engage with health care though. That's dangerous at any age.

@Crumpetring like it or not, there are additional
risks as a result of pregnancy at an older age - and not engaging with medical checks which can help improve your odds seems curious.

The glucose test is hardly invasive or difficult. Better to know for sure that you aren’t developing gestational diabetes, than wait for additional effects from it to appear.

At this stage of pregnancy the glucose is likely to be offered purely based off age. It’s unpleasant and a fairly blunt instrument. The threshold for diagnosis is also low. It was lowered a few years ago and studies have shown that lower the threshold did not improve outcomes.

If it seems there is actually an issue relating to glucose in this pregnancy there will be other signs/opportunities to pick this up. It can be confirmed or ruled out either way with blood sugar monitoring, not just the oral glucose tolerance test.

Women don’t have to blindly agree to every investigation offered in pregnancy.