(USA Today) -- Having diabetes and being an older mother pose multiple health risks for both Halle Berry and her unborn child, but the latest advances in testing and medical care will go a long way to guard against problems, experts say.
Berry, 46, and fiancé Olivier Martinez are expecting their first child together. The Hollywood actress told CNN the baby is healthy, she feels fantastic and she "thought I was past this point in my life." The baby-to-be will be Berry's second. She and ex-boyfriend Gabriel Aubry also have a child, Nahla, her 5-year-old daughter.
Any pregnancy after age 35 is considered risky, says physician Martin Chavez, but "the paradigm has drastically changed because of noninvasive tests that are available now. It's no longer the case of doom and gloom." He is chief of Maternal Fetal Medicine at Winthrop University Hospital in Mineola, N.Y.
The baby of an older mother is more likely to have chromosomal changes that can lead to serious birth defects, including Down syndrome and heart abnormalities.
The chances of having a child with Down syndrome at age 46 are about 1 in 18, or 5.5%, says medical geneticist Brian Skotko, co-director of the Down syndrome program at Massachusetts General Hospital in Boston.
Among medical advances for the fetus: A new blood test is a safer method to detect birth defects than amniocentesis (drawing amniotic fluid from the uterus with a needle) which carries a slight risk of miscarriage. Electronic fetal heart rate monitoring has been associated with a significantly decreased rate of neonatal death and infant mortality.
Berry's diabetes can create other risks.
"Mothers need to control their glucose levels or their babies can be be born larger,'' says physician Ranit Mishori, an associate professor of family medicine at Georgetown University Hospital. "That can pose problems at birth."
Older moms with diabetes are also more likely to miscarry or have stillbirths, but that's usually only in a case when the diabetes hasn't been adequately managed.
"We're assuming with Halle Berry that she'll have top medical care and good nutrition,'' says Mishori. "In that case everything could be fine for her and her baby."
For any mother 35 or older, there are also higher risks for developing breast cancer, since hormonal surges are occurring just as her natural risk for breast cancer is going up; and higher risks for placental abruption, when the placenta pulls away from the uterus and causes severe bleeding.
"Older moms are also at higher risk for developing high blood pressure and diabetes,'' says Mishori, "but it sounds like she's doing a good job monitoring her diabetes."