Typically the first pregnancy is more of a challenge, if for no other reason, because the patient has not been pregnant before.
I am in my early 40s. Do I need to take any special precautions during pregnancy?
Genetic abnormalities certainly rise in the 40s, even in the later 30s. Fortunately, testing is available and recommended to assure normal outcomes. Other diseases such has hypertension, diabetes, and thyroid problems are more common as patients get older and will have to be dealt with as well. As a rule, these patients are highly motivated and generally have good outcomes.