After the "three children" era, is your body ready?

Editor's Note

With the progress of the times and the rapid development of society, people's concepts and lifestyles have also quietly changed. Women shoulder multiple pressures such as work, life, and parenting, and women's health has become a topic of social concern. In March, Changsha Evening News sent holiday health gifts to women, and from now on, the health edition of this newspaper launched a series of reports on "Caring for Women's Health", focusing on changes in women's health, improving women's self-care awareness and disease prevention and control capabilities from multiple aspects such as women's fertility, menopause, and mental health, and jointly caring for women's physical and mental health.

Changsha Evening News all-media reporter Yang Yunlong

In recent years, with the pressure of life and work and the change of marriage and childbearing concepts, more and more people have married late or have children late, and after the introduction of the "three-child" policy, the proportion of elderly women over 35 years old has increased, and the probability of facing birth risks and fetal birth defects has increased.

After the "three children" era, are female friends ready?

example

Having another child, she was labeled a high-risk pregnancy

This is the second time Zheng Yuan has become a mother, and the eldest son has turned 12 years old. Compared with 12 years ago, the 40-year-old Zheng Yuan's mentality is completely different, taking care of her family and career promotion, which makes her carry heavy pressure. Bigger concerns plague both husband and wife at the same time – will there be problems with fertility as they get older?

Generally speaking, when a woman reaches or exceeds the age of 35, the doctor will write it down in the medical record: Advanced Maternal Age. They are naturally labeled as high-risk pregnancies, meaning that having children at this age increases dramatically in the likelihood of women developing various pregnancy complications, such as gestational diabetes and high blood pressure.

The older you get, the more your body and energy can no longer afford a child, and Zheng Yuan understands this. After the "two-child" policy was fully implemented, she went to the hospital to remove the birth control ring in her body and prepare to have a second child. When she first became pregnant, she was unaware of the presence of the fetus, ran a 50-kilometer marathon, and the next day the child was gone. She broke down and cried, and this matter became her heart demon.

With the landing of the "three-child" policy, she had the idea of having a child again, so she exercised her body and actively prepared for pregnancy. After finding out the "two bars" two months ago, she decided to give birth to the child. Labeled as a high-risk pregnancy, she knows the dangers of advanced maternal age, strictly controls her diet and pays attention to pregnancy tests every day.

Li Wen has given birth to two children, dabao in junior high school, erbao in elementary school when the "three-child" policy was relaxed, when she was 41 years old, and began to prepare for pregnancy. Eat a variety of traditional Chinese medicine to nourish, ovulation injections... There are many ways to get pregnant. Later, I was pregnant twice, but I didn't keep it, and finally I got pregnant, the fetus was stable, but the pregnancy hypertension and diabetes came.

Li Wen went to the hospital twice a week to hang up nutrition injections, and the whole family raised her as a panda. In the third trimester of pregnancy, the doctor told her to stay in bed to protect the fetus, Li Wen completely spent it in bed, and when she reached the due date, she was admitted to the hospital early to protect the fetus. When she gave birth, the dystocia increased the bleeding, several doctors ran into the delivery room, and finally general anesthesia, caesarean section to save the adults and children.

data

The proportion of women of non-optimal childbearing age aged 35 and over is increasing year by year

At present, due to the postponement of the age of marriage, the rising cost of parenting and the implementation of the "three-child" policy, the increase in the number of elderly women is an indisputable fact. According to the National Bureau of Statistics, the proportion of women of non-optimal childbearing age aged 35 and above among women who have registered marriages in the mainland is increasing year by year.

The reporter learned from Hunan Provincial Maternal and Child Health Hospital, CITIC Xiangya Reproductive and Genetics Specialist Hospital and other hospitals that the age distribution of "second-child" mothers is mainly between 33 and 45 years old, and about 25% of "second-child" mothers under 33 years old. In the past two years, the number of "three-child" mothers over the age of 40 has increased significantly.

Limited by a variety of conditions, many elderly "two-child" mothers and "three-child" mothers are naturally difficult to conceive successfully, and they are unwilling to give up the "second child dream" and "three-child dream" And finally choose IVF. At CITIC Xiangya Reproductive and Genetics Specialist Hospital, there are long queues every day. "Among the people receiving assistive medical technologies such as IVF, the proportion of 'two-child' mothers and 'three-child' mothers is rising rapidly." Experts from the hospital told reporters.

The high-risk label of advanced maternal age is something that no woman is born with, and it is accompanied by severe pain and life-threatening. As said in the documentary "Shengmen", childbirth is like a door, outside the door is waiting for the expectation and joy of newborns, but inside the door is the thrill of fighting with the god of death, and the elderly mothers are even more so.

remind

In the "three-child" era, these risks should be understood

"After the implementation of the 'three-child' policy, the physical and mental health of elderly mothers and babies is an issue that we need to focus on." Jia Xiaozhou, director and chief physician of the Second Department of Obstetrics of Hunan Provincial Maternal and Child Health Hospital, said.

"Removing all kinds of subjective and objective factors, no matter how many children you consider and when you have children, there is a key condition that cannot be ignored: whether your body is suitable for having a healthy child." Jia Xiaozhou reminded that women need to be "age-appropriate" for childbearing, and the best age for childbearing is under 35 years old. Compared with young pregnant women, the various functions of the elderly women's bodies have declined, not only difficult to conceive, but also easy to miscarry after pregnancy, high incidence of birth defects, complications of pregnancy complications and the probability of dystocia; the previous higher caesarean section rate, resulting in an increase in the rate of scar pregnancy and an increase in the incidence of placental implantation; women who repeatedly undergo artificial pregnancy termination are more likely to have postpartum bleeding, uterine rupture, etc.; the older they are, the higher the possibility of complications such as postpartum depression, gestational diabetes, and gestational hypertension.

Related to the fertility of elderly women, there is also the problem of baby birth defects. A large number of clinical data show that the birth defect rate of children born to children over 35 years old is more than 10 times higher than that of normal people. Taking the average incidence of Down syndrome as an example, the risk of Down syndrome in children born to 21-year-old pregnant women is 1/1667, the risk of Down syndrome in children born to 31-year-old pregnant women reaches 1/909, the risk of down syndrome in children born to 41-year-old pregnant women soars to 1/81, and the risk of Down syndrome in children born to 49-year-old pregnant women is as high as 1/11.

suggestion

The "third child" who is planning to conceive needs to undergo a fertility assessment as soon as possible and when necessary

Professor Lu Guangxuan, Chief Scientist and Honorary President of CITIC Xiangya Reproductive and Genetics Specialist Hospital, said: "With the increase of age, fertility begins to decline, especially after the age of 35, the decline in fertility is more obvious, and 35 years old is also the dividing point of women's advanced reproductive age. The so-called 'fertility is not waiting for people', when you have time and money, but you may not be able to have children. Therefore, women should give birth at the right age, and the 'three children' who are ready to conceive need to be pregnant as soon as possible, and if necessary, they need to carry out fertility assessment and prepare for pregnancy. ”

Elderly women should pay attention to the following matters in pregnancy: oral folic acid 3 months in advance, preferably folic acid and other elemental complex preparations; pay attention to balanced nutrition, ensure the supplement of vitamins and minerals, do a good job of weight management; develop good living habits and regular diet and living, maintain a good attitude; avoid all potentially harmful pollutants; undergo health checks before pregnancy to find out whether there is hypertension, diabetes, hyperthyroidism and other diseases, if there is treatment, the condition is stable and then pregnant, and regular obstetric examinations after pregnancy.

Jia Xiaozhou reminded elderly pregnant women that they must carry out prenatal and prenatal examinations on time and undergo high-risk screening, so that medical institutions can timely include pregnant women with high-risk signs into high-risk pregnancy management and establish appropriate referral routes.