Older, pregnant and smart

Christina Applegate is doing it. So is Alanis Morissette. Kelly Preston and Celine Dion, too. They're all having babies after age 35.

If you're pregnant and at a similar age, there's good news.

"The majority of women over age 35 have healthy pregnancies and healthy babies," said Jim Link, an obstetrician/gynecologist with Partners in Women's Health in Louisville. "There's really not any preset age that's unsafe for any one patient to become pregnant."

But there are some things to think about.

"Pregnancy is a one-year project -- three months to get tuned up and then nine months to do the pregnancy," said Stanley A. Gall, a professor of obstetrics, gynecology and women's health at the University of Louisville.

"Consider what kind of health you're in," Gall said. "It becomes important to maintain good health because healthy moms are more likely to have healthy babies."

Schedule a pre-pregnancy visit. Some physicians recommend visiting an OB/GYN before getting pregnant. The doctor can review your medical history and "determine what things, potentially, besides age, are going to be risk factors for that pregnancy," Link said.

The doctor is likely to consider such things as, "Are your vaccinations up to date? Are you in a good body-mass-index range? Is your blood pressure normal? Is your renal function good?" said Link. Some things can be addressed "prior to conceiving and make your life a whole lot easier, not to mention the baby's," he said.

Follow your doctor's instructions. Your doctor probably will want you to take at least 400 micrograms of folic acid a day to reduce the chance of neural tube defects, such as spina bifida, and to take steps to get troublesome medical conditions, such as diabetes and high blood pressure, under control. You also might be asked to change medications.

Be aware of medical conditions that can affect older mom.

"When women conceive over the age of 40, there's a greater incidence of gestational diabetes, preeclampsia and other medical complications," said Steven Nakajima, director of reproductive endocrinology and infertility at the University of Louisville. "It's a taxing effort on your body."

Women older than 35 have a higher chance of having a child with Down syndrome than women who are younger.

Here is some specific advice for older women:

Watch your weight. Older women who are heavy tend to have problems such as diabetes, high blood pressure and asthma during pregnancy, said Stanley A. Gall, a professor at the University of Louisville.

Genetic counseling. This can help determine the risk of passing down an inherited disease. It also may provide clues to couples who've experienced recurrent miscarriages. And it can give some couples "peace of mind," said Jim Link, an obstetrician/gynecologist with Partners in Women's Health in Louisville.

Make smart choices. "It's never too late to make positive health changes," such as "stopping smoking, minimizing your stress, trying to get a regular amount of cardiovascular exercise on board, really rounding out your nutrition -- doing away with fast food, minimizing the processed foods, minimizing the high-sugar foods, minimizing your caffeine intake," Link said. "There's a lot of nutritional things that you can do."

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