Having a baby when you're over 35 can mean more health concerns and extra tests, but it shouldn't be cause for alarm or distress. In fact, nearly 1 in 10 babies are born to women over 35, and the majority are delivered without complications. "Women over 35 are at higher risk for developing high blood pressure and gestational diabetes, but with good prenatal care, they should be off to a healthy start," says Lynn Simpson, M.D., an ob/gyn at Columbia Presbyterian Medical Center in New York City. Here, a look at what older pregnant women should consider:

General health Women this age need to eat properly, exercise, and attend all prenatal appointments. "Since older women tend to be a bit heavier, they should follow a well-balanced diet throughout pregnancy," says Dr. Simpson. Most women need to add about 300 calories to their daily diet.

Testing It's standard for women over 35 to be offered genetic testing, as the risk of chromosomal abnormalities increases at this age. You can usually choose between a chorionic villus sampling (CVS) at 9 to 11 weeks or an amniocentesis at 15 to 16 weeks. (Miscarriage risks are a bit higher with the CVS test.) If the results are positive, further tests or counseling can be arranged, says Maria Hayes, M.D., a reproductive endocrinologist at Oakwood Hospital in Dearborn, Michigan.

Complications Pregnancy in women over 35 can trigger high blood pressure and diabetes, and the risk of preeclampsia (pregnancy-induced hypertension) may also increase. The risk of miscarriage and stillbirth goes up with age as well, possibly due to chromosomal abnormalities or uterine fibroids (benign tumors found in nearly one-quarter of women over 35), which may interfere with fetal development. The incidence of twin births also increases and can cause preterm labor, which occurs in almost half of all multiple pregnancies. Older women have a higher rate of cesarean sections as well, which involve a longer recovery.

Emotions Moms-to-be over 35 are usually ready for the life change that comes with the birth of a baby. Managing the emotions and added strain that may accompany pregnancy, however, is important as high stress levels have been linked to an increased risk of complications. In addition to eating well and exercising, making time to relax should be a priority. Yoga, massage, and leaning on a support network of friends and family will help expectant mothers wind down during this emotionally charged time. For more information, check out Your Pregnancy After 35 by Glade Curtis, M.D., and Judith Schuler, M.S.; the March of Dimes

---