GestaCare Gestação 35+

Our society has undergone significant changes in habits and lifestyle in recent decades. People are developing their personal, academic and professional projects later in life, they are spending several years structuring a professional career and their financial stability, and they are often putting off maternity projects.

In recent decades, the rate of pregnancy at an advanced maternal age has increased, requiring more specialized obstetric surveillance.

Advanced maternal age is defined as childbirth at the age of 35 or over, but recently most protocols in this area have used 40 as the lower limit for the definition of advanced maternal age. It should always be emphasized that, with advancing maternal age, there is a decline in fertility with all the underlying psychological and social impact.

What are the associated risks?

Being a first-time mother after a certain age can have some disadvantages from a clinical point of view. In the case of the mother, there is an increased risk of gestational diabetes, high blood pressure, placenta previa, miscarriage or premature birth. In the case of the fetus, there are malformations and chromosomal defects, such as Down’s Syndrome.

Experts warn that although this is a pregnancy that statistically has a higher risk of morbidity , with more maternal and fetal complications, it is not contraindicated. Pregnancy at an advanced age requires special vigilance, but as long as there is adequate monitoring, the likelihood of everything going well is very high.

Despite the increased risk of maternal and fetal/neonatal complications, the majority of these pregnancies occur without major complications and most of these babies’ outcomes are normal.

What can be done to prevent and reduce risks?

In order to reduce the risk of complications, it is essential to increase prenatal care in pregnancies over the age of 35, and this care should begin in the pre-conception period. It is therefore advisable to

• Make a pre-conception assessment appointment with a gynecologist/obstetrician;
• Identify any pathologies;
• Assess chronic diseases (hypertension, diabetes, obesity, osteoarticular diseases, among others) and stabilize them with the support of various specialists before starting to try to get pregnant;
• Use tests such as amniocentesis (collection of amniotic fluid to accurately detect abnormalities in the fetus); biochemical tests (biochemical marker method); chorionic biopsy; the latest fetal DNA tests (via maternal blood) and sequential ultrasounds during pregnancy;
• Carry out all requested surveillance;
• Follow the obstetrician’s recommendations;
• Stop smoking and consuming alcohol or other substances that are contraindicated in pregnancy;
• Take adequate supplementation, particularly of folic acid, vitamin D3, iodine, choline and other micronutrients essential for maintaining good maternal health, ensuring better fetal development and preventing the development of birth defects;
• Maintaining a healthy weight and eating a healthy, varied and balanced diet.

Quatrefolic® (Vitamin B9, Folic Acid) or Bioactive Folic Ac id is a patented biologically active folate that differs from the synthetic folic acid normally found in other supplements in that it is a final form of folate that the body can immediately use without any need for metabolization, thus guaranteeing the recommended daily dose and preventing a potential build-up of unmetabolized folic acid in the blood.

This new folate plays an essential role in DNA synthesis, cell division and proper fetal growth.

It is also essential for preventing congenital anomalies in the developing fetus and helps the development of the newborn in the first few months of life. This is the most up-to-date and advanced form of folate, which is why taking it is considered essential for all pregnant women throughout the pre-conception, pregnancy and post-natal stages.

Bioavailability and efficacy

Unlike synthetic folic acid, Quatrefolic® is in its active form, which means that it is readily absorbed and used by the body without the need for metabolic conversion.

Quatrefolic® vs isolated folic acid

Choosing to supplement with Quatrefolic® instead of folic acid alone offers a number of significant advantages, including better bioavailability, guaranteed efficacy in people with mutations in the MTHFR gene, immediate absorption and utilization, and reduced risk of accumulation of unmetabolized folic acid. These advantages make Quatrefolic® a superior choice for ensuring adequate folate intake, especially in critical periods such as pre-conception and pregnancy.

Quatrefolic^® is a registered trademark of Gnosis Spa. Copyright© 2018 Gnosis S.p.A. All rights reserved.

It is established that 80% of women experience nausea and vomiting during pregnancy, with special severity in the first trimester of pregnancy. Thus, there are many women who suffer from indisposition, nausea and vomiting, with a reflection on the feeding and intake of micronutrients indispensable to the formation of the fetus.

Even in moderate situations, studies highlight the importance of encouraging pregnant women to seek help from their attending physician!

Find out more here about the NauseaStop® ginger source in GestaCare Pregnancy 35+.

Choline is a vital nutrient during pregnancy. Adequate supplementation can contribute significantly to the health of the fetus and the mother, helping to ensure the healthy development of the baby’s nervous system and preventing complications related to pregnancy and the postpartum period.

Although choline can be obtained through the diet, the average intake may not be sufficient during pregnancy. Foods rich in choline include eggs, meat, fish, nuts and legumes. However, supplementation may be necessary to ensure that the increased needs during pregnancy and lactation are met.

Development of the fetal nervous system

Choline is essential for the development of the fetus’ brain and spinal cord. This nutrient contributes to the formation of memory and the hippocampus, the region of the brain responsible for memory and learning. Studies have shown that choline supplementation during pregnancy can improve the baby’s cognitive functions in the long term.

Prevention of neural tube defects

Choline, together with folic acid, helps prevent neural tube defects such as spina bifida. These defects occur in the first few weeks of pregnancy, so it is crucial that women in the pre-conception and early pregnancy stages have adequate levels of choline.

Liver function

Essential for liver health, preventing the accumulation of fat in this organ. During pregnancy, the mother’s liver works intensively to metabolize nutrients and provide energy for both mother and foetus, making choline even more important.

Regulation of metabolism and cell growth

Necessary for the synthesis of phospholipids, such as phosphatidylcholine. These are crucial for the structure and function of cells. Choline is also involved in cell signaling and methylation, an important biological process for regulating gene expression.

Mother’s mental health and well-being

Adequate levels of choline can help prevent mood disorders and improve the mother’s cognitive function in the postpartum period. Choline is the precursor to acetylcholine, a neurotransmitter involved in memory and mood regulation.

Editorial Note: This page and all other contents present in
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are prepared and reviewed by medical experts in Portugal.

Sources:

Frick AP. Advanced maternal age and adverse pregnancy outcomes. Best PractRes Clin ObstetGynaecol, 2021 Jan;70:92-100.

Claramonte NietoM. Impact of aging on obstetric outcomes: defining advanced maternal age in Barcelona. BMC Pregnancy Childbirth, 2019 Sep 23;19(1):342.