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

[Nordicdaydream]

My sister is pregnant (24 weeks). She is 46 and conceived naturally. She’s had quite a few miscarriages in the past and has one son already who is 6.
I am concerned at the risks once she gets further along. They are monitoring her with growth scans and she’s had a regular appointments but they offered her the glucose test for gestational diabetes and she’s refused it. She also refused the NIPT Down syndrome test.

I suppose I’ve been researching and worried for both her and the baby as I know things are more likely to be complicated at this age.

Has anyone else had a natural pregnancy around this age? And were there complications?

Worry by all means but please don’t pass your stress on to her. If you are worried so is she.

I haven’t mentioned any of my concerns to her.

What good does worrying achieve?

@Happytaytos it doesn’t, but I just wanted to see if others have been a similar situation

A good friend of mine has just given birth to a perfect healthy baby at age 45, zero complications for either mother or baby.

Why is she refusing routine medical care like the glucose test? Refusing to engage with normal
medical care is a far greater issue than her age.

Is she fit? Is she strong? I’m 44 and would be totally fine in terms of my body and energy now to carry a baby vs 10yrs ago.

Thats natural to be concerned for her and the baby. . No doubt she’s concerned as well.

Refusing the test could be that she’s denying that anything could could wrong, or she’s going to love this baby, whether s/he’s got downs or not.

It’s perfectly reasonable that someone would refuse a NIPT test. She has already had a child at 40 so she must be aware that risks rise with age. Not much you can do/say.

Was there anything I indicate that she needed the NIPT Down syndrome test? Did the normal screening come back very high risk?

After so many miscarriages your sister maybe be very sure that she is keeping this baby regardless.

Pregnancy is always a risk. She will have doctors telling her at every appointment that she higher risk because of her age.

Try and be happy for her, don’t voice your concerns, she doesn’t need them. How wonderful that’s she’s probably been trying for a baby for the last 6 years and has now got to 24 weeks naturally at 46. This is cause for celebration.

I would be more worried about having a baby that age in general tbh. Both my parents and in laws started getting health issues in their 50s.

But i’m not sure what you can do about it tbh. So maybe try to stop worrying as it’s out of your control.

YABVU

1 it’s none of your business
2 posting about your sisters pregnancy online and her personal choices is just plain rude and not sisterly at all. It’s just judgemental

I can see why your sister has refused the test for Downs Syndrome if she wouldn't want to abort the baby if they did have Downs Syndrome.

I cannot understand why she wouldn't have the glucose tolerane test as undiagnosed or uncontrolled gestational diabetes is highly dangerous for both mother and baby.

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.

@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.

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.

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.

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

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

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.

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 😊

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 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.

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.

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.

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.