Pregnancies in older women are increasing. These women often have comorbidities. These pregnancies, spontaneous, after IVF or egg donation are at high risk of complications, particularly hypertension, preeclampsia, gestational diabetes, low birth weight, and delivery by cesarean section. Women with Turner syndrome can conceive only by egg donation and are at very high risk of cardiovascular complications. Screening of these comorbidities and pregnancy care by maternal-fetal medicine specialists, with pluridisciplinary collaboration, are mandatory. Delivery in a tertiary care center able to offer optimal care to the mothers and their newborns is recommended.