Advanced pregnant women are women whose gestational age is greater than 35 years old, and it is generally believed that the best age for women to give birth is between 25 and 29 years old. As the gestational age increases, the risk of pregnancy complications and complications during pregnancy and delivery increases, and abnormalities such as premature birth, stillbirth and malformed babies are likely to occur. The latest demographic survey shows that with the change of social structure, the trend of women marrying later and having children later is gradually obvious. Since the full implementation of the national two-child policy in 2015, the number of senior pregnant women in China is rapidly increasing, and obstetricians are under great pressure. The key to preventing maternal and child complications and avoiding adverse pregnancy outcomes is how to do a good job of pregnancy care for senior pregnant women before and during pregnancy. What are the risks faced by pregnant women of advanced age? Compared to pregnant women of childbearing age (women of childbearing age, ranging from 15 to 49 years), the complications that increase with childbearing age do not subside, despite the higher level of education, better financial means, higher social status and good awareness of health campaigns. The incidence of infertility, stillbirth, fetal malformations, gestational diabetes and gestational hypertension in older pregnant women is significantly higher since the age of 35. The rate of spontaneous abortion and fetal malformation in older women increases. Investigation shows that the rate of spontaneous abortion in women <35 years old is 10%-15%, and the rate of spontaneous abortion after 35 years old is 25%, and the rate of spontaneous abortion after ≥40 years old is 35%. The significantly higher rate of spontaneous abortion in older women is obviously related to the decrease of ovarian function and the quality of fertilized eggs. In addition, the general intrauterine environment in older women is not conducive to pregnancy maintenance and is associated with an increased incidence of medical comorbidities (e.g., chronic hypertension, diabetes mellitus, and thyroid disease). Advanced age predisposes genetic material to aberrations and abnormalities, and older women ≥35 years of age face a 1.6 to 2.6 times higher risk of adverse perinatal outcomes such as perinatal death, low birth weight babies, preterm delivery, fetal chromosomal abnormalities, and fetal malformations than those aged 20 to 34 years. Pregnancy management for older women: Improve preconception assessment: For women with high-risk factors but who wish to have another baby, preconception counseling is necessary to fully assess the risk of another pregnancy and intervene in a timely manner for pregnancy complications. For example, check weight, blood pressure, blood glucose and thyroid function; pay attention to menstrual status and exclude gynecological tumors; pay attention to the condition of the uterine incision in women with a history of cesarean delivery; provide guidance on reasonable diet and exercise. Screening during pregnancy: All pregnant women of advanced age should have ultrasound measurement of fetal nuchal translucency thickness (NT), nasal bone and neural tube for defects on week 11-13+6 days of gestation. If there are abnormalities in the above ultrasound soft indicators, chorionic villus biopsy or amniocentesis is feasible to find out whether there are chromosomal abnormalities. Non-invasive DNA is recommended at 12-14 weeks of gestation in advanced pregnancies, whether singleton or twin pregnancies, to determine whether the fetus has chromosomal disorders (e.g. 13, 18, 21-trisomy), with an accuracy rate of 99%. If abnormalities are found in the non-invasive DNA test, it is important to review and confirm the diagnosis by chorionic villus biopsy or amniocentesis to decide whether to terminate the pregnancy. Improve postpartum rehabilitation: Appropriate psychological counseling can be provided after delivery to prevent and reduce the occurrence of postpartum depression; pelvic floor rehabilitation training and guidance can also be strengthened, and guidance on parenting for advanced maternal age can be improved, while attention is paid to publicity and guidance during the puerperium. With the increase in the number of elderly and high-risk pregnant women, it is important to strengthen pre-conception and pregnancy management. It is possible to set up clinics for senior pregnant women and scarred uterus re-pregnancy clinics; take multiple measures to reduce the birth rate of defective children; avoid maternal and fetal-related risks and reduce perinatal complications, and welcome the arrival of healthy babies.