Women Advised to have Children at Young Age.

WOMEN waiting to have children at a later age may be doing more harm than good.

                                                                                                                                                                       

This was the message being delivered by prominent obstetricians and gynaecologists at the launch of the first specialised multidisciplinary cardiac clinic in pregnancy at Mt Hope Women's Maternity Hospital yesterday.

Obstetrics Professor Mark Johnson said they were in no way trying to condone teenage pregnancies, "but certainly choosing to have a baby younger in your relationship, your established relationship, will be a good idea".

"We know in the UK for example, the age of people first giving birth is around age 30, if you had your first child around 20, average, that would be much better," he said.

Consultant obstetrician and gynaecologist Dr Bharat Bassaw added that there was evidence to show that women waiting to have children at a later age were not only risking the life of their child, but their own.

Bassaw explained that the presence of maternal heart disease had an adverse effect on pregnancy outcomes, particularly in older women. He added that research has also confirmed that heart disease is now the most common cause of maternal death, while maternal and neonatal morbidity was also significant.

"Many of these women are at a very high risk of dying in the pregnancy; I think that is actually what stimulated this collaboration," he said.

Mt Hope Women's Maternity Hospital has teamed up with Johnson, who is part of the Chelsea and Westminster Hospital High Risk Pregnancy Team in England, to deliver the very first cardiac clinic at the hospital.

According to Bassaw, while they never had a maternity clinic catering to cardiac issues, at risk patients would have been seen by general practitioners.

"The level of antenatal care would have been haphazard because they would have been seen by general practitioners or general anaesthetists.

"So this is adding a new dimension, taking a new level of care to a very high level where we will be using best evidence in medicine and we will be using recognised policies, procedures and guidelines in order to foster the highest level of care," he said.

Bassaw added that the goal of the clinic would be to stimulate the development of similar clinics in other areas of obstetrics and gynaecology, while reducing the maternal mortality rate.

He explained that they will be screening patients and conducting tests, which would be further scrutinised by staff at Chelsea and Westminster Hospital, to ensure "healthy deliveries".

"Right now, our maternal mortality rate in this country is very high, when we look at our figures at Mt Hope Maternity, the latest research, it was 33 per 100,000.

"What has been happening actually, our figures are rising and this is obviously in the wrong direction," said Bassaw.

The clinic was created without having to expend any finances, but Bassaw said they would need the Ministry of Health to commit to ensure they have proper machinery, such as the fetal echocardiography machine used to monitor the baby's heart rate.

Delivering the feature address was Hamid O'Brien, adviser to the Minister of Health--who was unable to attend the launch due to other pressing engagements—who added that in many developed and developing countries, maternal heart disease was one of the leading causes of death during pregnancy, while the overall rate of mortality has tripled over the last 30 years, rising from 7.3/million births in 1982-1984 triennium to 22.7/million births in 2003-2005 triennium.

The clinic will commence operations every Wednesday beginning next month and visits will be done via referrals from both public and private medical institutions.

reproduced verbatim from express Trinidad.