BioEd Online

A Romanian woman set a world record on Sunday when she gave birth at the age of 66. Adriana Iliescu gave birth to a daughter, Eliza Maria, by caesarian section at the Giulesti maternity hospital in Bucharest on 16 January.

Iliescu became pregnant after undergoing artificial insemination using donor eggs and sperm from "healthy young people", says hospital chief Bogdan Marinescu. She is also believed to have received hormone-replacement therapy to ensure that her womb could successfully host the embryos.

Eliza Maria was delivered about six weeks prematurely. She weighed 1.4 kilograms, less than half the weight of an average newborn. Doctors decided to perform the caesarian section after a fellow fetus died of heart failure. Iliescu was originally carrying triplets, but one fetus died around nine weeks into the pregnancy.

The record-breaking mother and baby are both reported to be healthy and could go home in the next few days. At 66, Iliescu is older than an Indian woman reported to have given birth two years ago at 65. She also beats the 63-year-old mothers listed as title-holders in the Guinness World Records, Italian Rosanna Della Corte and Californian Arceli Keh.

Significant burden

Despite the successful birth, medical experts have condemned the development, saying that the strain could have proved too much for such an elderly mother. "My personal opinion is that it was completely irresponsible and shouldn't have gone ahead," says Richard Kennedy, spokesperson for the British Fertility Society.

Pregnancy places an increased burden on the heart, Kennedy says. And a typical woman in her mid-60s is likely to have some degree of coronary heart disease. What's more, the ordeal of childbirth can lead to the formation of dangerous blood clots in the veins.

Added to this are the potential problems posed by motherhood at such a late stage of life. Even if Iliescu far outlives the average Romanian life expectancy of 73, Eliza Maria faces the loss of her mother relatively early in life. "There are ethical concerns for a mother who is old enough to be her daughter's great-grandmother," comments Kennedy.

There is no law in Romania to limit the age at which a woman can receive fertility assistance. But the British Fertility Society recommends that women do not receive such treatment beyond 50, the average age at which menopause occurs.

A 2002 study¹ of women who gave birth in their 50s using donated eggs concluded that "there does not appear to be any definitive medical reason for excluding these women from attempting pregnancy on the basis of age alone", although such mothers are at slightly increased risk of high blood pressure and diabetes during pregnancy.

But for elderly mothers, the real challenge may come years after birth, comments Jonathan Muraskas, a paediatrician at the Loyola University Medical Center in Maywood, Illinois. "It's going to be hard for an 80-year-old lady to raise a teenager," he says.