做高齡媽媽 也許是一件好事

The first time I got pregnant, I was a comparatively young mother, for my demographic: I was 25, in medical school, surrounded by classmates who, for the most part, were not reproducing yet. By the third pregnancy, 11 years later, I was over 35, which classified me, in the obstetric terminology I had learned in medical school, as an “elderly multigravida,” that is, someone who was having a child but not her first child, after 35. (If it was your first child, you were an “elderly primigravida,” or “elderly primip” for short — even as a medical student, I had a strong sense that no woman had invented this terminology.)

第一次懷孕時，就我所在的羣體——25歲、醫學院學生、身邊的同學大部分都還沒生孩子——而言，我是一個相對年輕的媽媽。到11年後第三次懷孕時，我已經過了35歲了。按照我在醫學院學到的產科術語，我屬於“高齡經產婦”(elderly primigravida)，即在35歲之後生孩子但不是第一個孩子的人（如果是第一個孩子，那就是“高齡初產婦”——即便作爲一名醫學院的學生，我也強烈地覺得發明這個術語的人不是女性）。

So by certain standards, I have experience as both a somewhat younger mother and a somewhat older mother, though not at the extremes in either direction.

因此，按照某些標準，我既有作爲比較年輕的母親，又有作爲年紀較大的母親的經歷，儘管在這兩個方面都不算極端。

National Vital Statistics Reports data released in January showed that in the United States, birthrates shifted in 2015: The birthrate for teenagers dropped to 22.3 births per 1,000 females ages 15 to 19 that year, a record low for the nation. And for women 30 through 44, the birthrates were the highest they have been since the baby boom era of the 1960s.

1月公佈的《國家生命統計報告》(National Vital Statistics Reports)數據顯示，2015年美國的出生率發生了變化：青少年中的出生率跌至每1000名15到19歲的女性生育22.3個孩子，創下美國曆史最低水平。而在30到44歲的女性中，出生率達到了60年代嬰兒潮時期以來的最高點。

And as birthrates shift toward somewhat older mothers, researchers continue to look at what that says, both about who is getting pregnant when, and how that is associated with how their children do, especially when it comes to cognitive outcomes. (There’s also been some interesting research recently on paternal age, but these studies focused on the mothers.)

隨着出生率向年紀較大的母親轉移，研究人員繼續研究這意味着什麼——關於什麼人在什麼時候懷孕，以及這對孩子的表現的影響，尤其是在認知能力方面的影響（最近也有關於父親年齡的有趣研究，但這些研究的重點卻是母親）。

The trend all over the developed world in recent years has been more women having more children later; mean age in the United States at birth of a first child increased from 24.9 to 26.3 from 2000 to 2014. And whether it’s a first child or a later child, more women giving birth are 35 and older, which is still classified as “advanced maternal age” (well, it beats “elderly”).

近年來，發達國家的趨勢是，更多女性會在年齡大一些的時候要更多的孩子。美國生第一個孩子的年齡中位數從2000年的24.9歲增大到了2014年的26.3歲。無論是不是第一個孩子，在35歲及以上的年紀生孩子的女性增加了。這些人依然被歸爲“高齡產婦”（advanced maternal age，好吧，advanced好歹比elderly好一點）。

In a study published in February in the International Journal of Epidemiology, researchers looked at evidence from three different large longitudinal studies in Britain, from 1958, 1970 and 2000-2, each involving around 10,000 children. They were looking at the association between maternal age at children’s birth and children’s cognitive ability when tested at age 10-11.

在2月刊登在《國際流行病學雜誌》(International Journal of Epidemiology)上的一項研究中，研究人員研究了來自英國三項不同的大型縱向研究的證據。這三項研究分別是在1958年、1970年和2000~2002年之間進行，各自都有大約1萬名兒童參加。他們研究了母親生孩子時的年齡，和孩子在10到11歲時所測得的認知能力之間的關係。

In the two earlier studies, there was a negative association; maternal age 35-39 at birth was associated with poorer cognitive scores in the children, tested a decade later; the children who had been born to mothers 25-29 did better. On the other hand, for the most recent study, that association was reversed; the children born to the 35- to 39-year-olds did significantly better on the cognitive testing than the children born to the younger mothers.

前兩項研究顯示兩者呈負相關；孕母年齡在35至39歲之間，孩子於十年後接受認知測試，分數較低；孕母年齡在25至29歲之間，孩子的分數較高。另一方面，在最近一項研究中，兩者的關係出現了逆轉，孕齡在35至39歲之間的母親生下的孩子參加認知測試時的表現，大大好於較年輕的母親生下的孩子。

What had changed over time? The researchers found that they could explain this reversal by correcting for the social and economic characteristics of the mothers; different women, in different circumstances, were having their children later in life.

是什麼隨着時間的推移發生了變化？研究人員發現，通過把母親的社會經濟特徵納入考量，可以解釋這種逆轉；在年歲較大時生孩子的，是有着不同條件的不同女性。

Alice Goisis, a research fellow at the London School of Economics and Political Science and the Max Planck Institute for Demographic Research in Germany, and the lead author on the study, said, “the characteristics of older mothers have changed drastically over time.” In the older studies, she said, the women who were having children into their late 30s were more likely to be women who had many children, and possibly poorer, whereas in the later study, the millennium cohort study done in 2000-2, the older mothers were more likely to be educated, and socioeconomically better off. Twenty-six percent were giving birth to their first child at ages 35-39, as opposed to 11 percent in the 1958 study.

這篇論文的第一作者、在倫敦政治經濟學院(London School of Economics and Political Science)以及德國羅斯托克的馬克斯·普朗克人口研究所(Max Planck Institute for Demographic Research)擔任研究員的艾麗斯·寇希斯(Alice Goisis)說，“隨着時間的推移，高齡母親的特徵發生了巨大變化。”她說，在早前的研究中，那些在30多歲的年紀生孩子的女性，更有可能育有多個子女且較爲貧窮，而在後一項研究，也就是於2000至2002年開展的千禧世代研究中，大齡母親更有可能受過良好教育，有着較高的社會經濟地位。在35至39歲之間生育第一個子女的女性佔比26％，相比之下，在1958年的研究中這一比例是11%。

“One question I am often asked is whether these results are suggesting that women should wait to have children so they will have smarter children, and the answer is that our results are not addressing that,” Dr. Goisis said. “These women tend to be advantaged,” she said, and to take better care of themselves during pregnancy; they were less likely to smoke and more likely to breast-feed, compared to the younger mothers.

“我經常被問及，這些研究結果是否意味着女性應當推遲生育，以便擁有更聰明的孩子，我的答案是，我們的研究結果不能回答該問題，”寇希斯說。“這些女性往往生活優越”，能在孕期更好地照料自己，她說；比起較年輕的母親，她們吸菸的可能性更小，以母乳餵養嬰兒的可能性更大。

“Nowadays children of older mothers have, on average, better outcomes because of the characteristics of women who tend to have children at older ages,” Dr. Goisis said.

“現如今的大齡母親生下的孩子平均而言表現較好，是由傾向於在年級較大時生育的那些女性的特徵決定的，”寇希斯說。

Other researchers have looked at the question of how parenting attitudes and practices change as mothers grow older. In a study published online in December, researchers looked at how parenting practices and children’s development varied with maternal age in a group of 4,741 families in Denmark. Older mothers were less likely to be harsh with their 7- and 11-year-old children, either in terms of scolding or of physical discipline, they found, and their children were less likely to have behavioral, social and emotional problems.

其他一些研究人員關注的問題是：隨着母親年紀變大，其管教態度和方法有何變化。在一篇於去年12月發表在網上的論文中，研究人員以丹麥的4741個家庭爲樣本，探討了管教方法以及孩子的成長髮育狀況如何因孕母年齡的差異而有所不同。他們發現，年紀較大的母親以訓斥或體罰的形式嚴厲對待7至14歲子女的可能性較低，其子女出現行爲、社會和情感問題的可能性也較低。

“Older mothers seem to thrive better,” said Tea Trillingsgaard, an associate professor of psychology at Aarhus University in Denmark, who was the lead author on the study. “The mothers have more psychological flexibility, more cognitive flexibility, more ability to tolerate complex emotional stimuli from the children.”

“年紀較大的母親似乎能更好地養育子女，”該論文的第一作者、丹麥奧胡斯大學(Aarhus University)心理學助理教授迪·特里林斯戈德(Tea Trillingsgaard)說。“這些母親有着更強的心理適應能力，更強的認知能力，更能包容來自子女的複雜情緒刺激。”

Again, the researchers looked to see whether these differences were explained by another factor, by educational level or socioeconomic status, but even after controlling for all the demographic and socioeconomic factors they had, they still found that older maternal age itself continued to be associated with these more positive outcomes. “Emotional well-being tends to increase with age,” Dr. Trillingsgaard said. “Age in itself may be an advantage.”

研究人員又一次評估了能否用另一個因素，也就是教育程度或社會經濟地位來解釋這些差異，但即便是在剔除了其所掌握的所有人口統計學和社會經濟因素後，他們仍然發現，較高孕齡本身仍然和這些較爲積極的結果之間有關聯。“情緒狀態似乎會隨着年齡的增長而得到改善，”特里林斯戈德博士說。“年齡本身就是一種優勢。”

We all know that fertility issues increase with older childbearing, with a large and complex fertility industry growing up in part to meet the needs of women who may have more difficulty conceiving later in life. But since having children is for most of us a huge and complicated decision, involving relationships, socioeconomic factors, geography, and the whole package of individual factors roughly summed up as life, love and the pursuit of happiness, decision making often doesn’t allow for simple planning where you target one age or another.

我們都知道，大齡生育會帶來更多生育問題。在某種程度上，正是爲了滿足那些或許會遭遇更多困難的大齡生育女性的需求，龐大複雜的生育產業纔會不斷髮展。但對大多數人來說，生育子女是一項重大而又複雜的決定，涉及種種關係、社會經濟因素、地理影響，以及大致可以被歸結爲生活的所有個人因素之和，因此在決策過程中，你往往無法簡單規劃要在這個或那個年齡生孩子。

The clear message is that the children of women with more support and better health habits do better cognitively, so it’s important to support mothers of any age. What you learn as you grow up, intellectually and emotionally, may help you in the complicated job of taking care of your own children. And after all, growing up and helping people grow up is what this is all about.

有一點很清楚，女性如果得到更多支持、擁有更好的健康習慣，其子女的認知能力會更強，因此給予母親支持是很重要的，不論她們處於哪個年齡段。你在心智和情感上走向成熟的過程中學到的東西，或許有助於應對照顧你自己的子女這一複雜的工作。不管怎麼說，成長以及幫助人成長，生活不就是這麼回事嗎？