According to the regulations of China’s Maternal and Infant Health Care Law and the regulations on maternal prenatal diagnosis, an expected age of delivery ≥ 35 years is defined as advanced maternal age. The incidence of fetal chromosomal abnormalities in advanced maternal age is significantly higher than that in women of appropriate age; therefore, in principle, amniocentesis is recommended for intrauterine diagnosis. Non-invasive DNA testing is a precision screening test, which only tests for three pairs of target chromosomes, 21, 18 and 13, and is not part of the diagnosis. Therefore, intrauterine diagnosis by amniocentesis should be recommended first for advanced maternal age. If a pregnant woman has contraindications to amniocentesis, such as placenta praevia, infectious diseases, concerns and rejection of invasive operations, gestational weeks <16 weeks or maternal RH-negative blood, non-invasive DNA testing can be performed first, if appropriate. However, subsequent labor and delivery examinations must pay attention to the tertiary ultrasound at 24 weeks of pregnancy and secondary ultrasound at 32 weeks of pregnancy, focusing on the presence of any ultrasound soft indicators. If the ultrasound suggests abnormalities, the need for amniocentesis for intrauterine diagnosis also needs to be re-evaluated.