Pregravid preparation, antenatal care, and prevention of obstetric complications in women of advanced reproductive age: a literature review

Aim: to summarize current evidence on reproductive health preservation in women of advanced reproductive age and to present clinically applicable approaches to preconception care, antenatal surveillance, and postpartum management. Materials and Methods . A review was conducted using publications indexed in PubMed/MEDLINE, eLibrary.ru, CyberLeninka, and Google Scholar from January 2014 to March 2026. Systematic reviews, meta-analyses, clinical guidelines, consensus statements, and original studies addressing age-related reproductive and obstetric risks were analyzed. Results . Advanced reproductive age is associated with increased risks of preeclampsia, gestational diabetes mellitus, preterm birth, fetal chromosomal abnormalities, and several perinatal complications. However, chronological age alone should not be used as the sole criterion for intensified surveillance. The most clinically relevant care-related components include preconception assessment of reproductive and somatic status, correction of modifiable risk factors, genetic counseling, selection of aneuploidy screening strategy, nutritional support, early preeclampsia risk assessment, screening for gestational diabetes mellitus, and individualized delivery timing. Conclusion . For women aged 35 years and older, a risk-oriented care model is clinically justified. The scope of assessment and preventive interventions should be determined not only by age but also by ovarian reserve, somatic comorbidity, obstetric history, and early antenatal screening results.