I. Introduction

With the changes in modern society, the childbearing age of women is gradually postponed, and the proportion of elderly mothers is increasing year by year. According to statistics from the Hong Kong Health Bureau, the proportion of elderly women aged 35 and above in Hong Kong reached 28.5% in 2022, an increase of nearly 10% from a decade ago. Older women are also at increased risk, and preeclampsia is one of the most common and serious complications. Preeclampsia not only poses a threat to the health of pregnant women, but also affects fetal development, and can even lead to serious consequences such as premature birth and placental abruption. Therefore, understanding the risks and preventive measures of preeclampsia is very important for elderly mothers.

2. What is preeclampsia?

Preeclampsia is gestational hypertension that usually appears after 20 weeks of gestation, and the main symptoms include high blood pressure (systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥90 mmHg) and proteinuria (abnormally elevated protein levels in the urine). In addition, patients may also experience symptoms such as headache, blurred vision, and upper abdominal pain. The pathological mechanism of preeclampsia is mainly related to vascular endothelial dysfunction and placental dysfunction. Abnormal development of the placenta can cause the blood vessels in the mother to constrict, leading to high blood pressure and organ damage. If left untreated, preeclampsia can worsen into eclampsia and even endanger the lives of the mother and baby.

Symptoms and pathological mechanisms of preeclampsia

• hypertension: systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥90 mmHg
• protein: 24-hour urine protein content ≥ 300mg
• Vascular endothelial dysfunction: Causes vasoconstriction and organ ischemia
• Abnormal placental function: Affects fetal nutritional supply and oxygen exchange

3. Risk of preeclampsia in older mothers

Research shows that age is one of the important risk factors for preeclampsia. The risk of preeclampsia in older women over 35 years of age is 2-3 times higher than that of young pregnant women, and the risk is higher in pregnant women over 40 years of age. Physiological changes in older mothers, such as decreased vascular elasticity and reduced metabolic function, increase the incidence of gestational hypertension. Additionally, older women often have other health problems, such as high blood pressure, diabetes, or a history of obesity, which can further increase the risk of preeclampsia. According to a study by the University of Hong Kong, 15% of elderly women have chronic hypertension, and the incidence of preeclampsia in such pregnant women reaches as high as 25%.

Risk factors for older mothers

4. Prevention and screening of preeclampsia

For elderly mothers, preconception check-ups are the first step in preventing preeclampsia. Checking blood pressure, blood sugar, and kidney function can help detect potential health problems early. During pregnancy, regular prenatal tests and blood pressure monitoring are equally important. The Hong Kong Society of Obstetrics and Gynecology recommends that high-risk pregnant women take low doses of aspirin (75-150 mg/day) from 12 weeks of gestation to reduce the risk of preeclampsia. In addition, calcium supplementation (1 to 1.2 grams per day) can also help prevent preeclampsia, especially for pregnant women who do not get enough calcium in their diet.

Preventive measures are recommended

• Pre-conception testing: Evaluate indicators such as blood pressure, blood sugar and kidney function
• Regular Product Inspection: Every 4 weeks, the frequency increases in high-risk individuals
• Low dose aspirin: Take from 12 weeks of pregnancy
• Calcium supplementation: 1 to 1.2 grams per day, especially for people on a low-calcium diet

5. Treatment and management of preeclampsia

The diagnosis of preeclampsia is mainly based on blood pressure and proteinuria test results. Depending on the severity, it can be divided into mild preeclampsia and severe preeclampsia. Mild patients may only need close monitoring and lifestyle modifications, while severe patients require medications such as blood pressure medications and magnesium sulfate (to prevent cramps). In some cases, doctors may recommend early birth to reduce the risk to the mother and baby. Postpartum follow-up is equally important, as people with preeclampsia are at increased risk of cardiovascular disease after childbirth.

Key points of treatment planning and management

• Mild preeclampsia: Closely monitor blood pressure and fetal condition
• Severe preeclampsia: Hospitalization for antihypertensive drugs and magnesium sulfate use
• Initial production: If the condition worsens, induction of labor may be required before 37 weeks
• Postpartum follow-up: Continuous monitoring of blood pressure and organ function

6. How can older moms have a safe pregnancy?

Elderly women need to communicate well with doctors, develop individual prenatal health check-up plans, and strictly follow the doctor's instructions. When it comes to diet, it is recommended to consume foods rich in protein, vitamins, and minerals, and avoid diets high in salt and sugar. Moderate exercise (walking, yoga for pregnant women, etc.) can also help you stay healthy. Psychological adaptation is equally important, and older mothers may face more stress, so it is necessary to establish a good support system (family, friends, professional counseling, etc.).

Pregnancy life advice

• Food and beverage adjustment: Eat more fruits and vegetables, whole grains, and high-quality protein
• Exercise moderately: 150 minutes or more of moderate-intensity exercise per week
• Psychological support: Participate in a pregnant woman group or receive professional consultation
• Get enough rest: Get 7-8 hours of sleep every day

7. Facing risks, being proactive and welcoming a healthy baby

Although the incidence of preeclampsia is high, it can be greatly reduced by scientific prevention and control. The key lies in early screening, regular monitoring, and aggressive treatment. Elderly mothers should maintain an optimistic attitude and work closely with the medical team to ensure the health of themselves and their babies. As long as they face the risks and take appropriate measures, older mothers can also have a safe pregnancy and welcome a healthy new life.

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