Objectives: In the industrialized world, the mean age at which mothers give birth to their first child has increased. The purpose of this article was to review the available evidence in order to optimize preconception care in women who have postponed childbearing to the later years of the reproductive life cycle.

Methods: Review of literature.

Results: There is a paucity of evidence and rigorous studies to advise mothers on the potential interventions for optimizing pregnancy outcome.

Conclusions: Evidence-based guidelines for advising women who postponed childbearing are scant, and further research in this important area is urgently needed.