A high-risk pregnancy is a pregnancy that involves increased health risks for the pregnant woman, the fetus or both. Certain health conditions and your age (being over 35 or under 17 when pregnant) can make a pregnancy a high-risk one. These pregnancies require close monitoring, to reduce the chance of complications.
What causes a high-risk pregnancy?
Factors that make a pregnancy high-risk include:
- Pre-existing health conditions
- Pregnancy-related health conditions
- Lifestyle factors (including smoking, drug addiction, alcohol abuse and exposure to certain toxins)
- Age (being over 35 or under 17 when pregnant)
What are common medical risk factors for a high-risk pregnancy?
People with many pre-existing health conditions have increased health risks during pregnancy. Some of these conditions include:
- Autoimmune diseases, such as lupus or multiple sclerosis (MS)
- COVID-19
- Diabetes
- Fibroids
- High blood pressure
- HIV/AIDS
- Kidney disease
- Low body weight (BMI of less than 18.5)
- Mental health disorders, such as depression
- Obesity
- Polycystic ovary syndrome (PCOS)
- Thyroid disease
- Blood clotting disorders
Pregnancy-related health conditions that can pose risks to the pregnant woman and the fetus include:
- Birth defects or genetic conditions in the fetus
- Poor growth of the fetus
- Gestational diabetes
- Multiple gestation (pregnancy with more than one fetus, such as twins or triplets)
- Preeclampsia (high blood pressure from pregnancy)
- and eclampsia (seizure from pregnancy)
- Previous preterm labor or birth, or other complications with prior pregnancies
What are the signs and symptoms of high-risk pregnancy?
Talk to your doctor right away if you experience any of the following symptoms during pregnancy, whether or not your pregnancy is considered a high-risk one:
- Abdominal pain that doesn’t go away
- Chest pain
- Dizziness or fainting
- Extreme fatigue
- Fetal movement stopping or slowing down
- Fever over 100.4°F
- Heart palpitations
- Vaginal bleeding or discharge
- Nausea and vomiting that is worse than normal morning sickness
- Severe headache that won’t go away or becomes worse
- Swelling, redness or pain in your face or limbs
- Trouble breathing
At what age is a pregnancy considered high-risk?
People who get pregnant for the first time after age 35 usually have high-risk pregnancies. Research suggests that they’re more likely to have complications during pregnancy than younger women. These may include early pregnancy loss or pregnancy-related health conditions, such as gestational diabetes.
Young people under 17 also have high-risk pregnancies because they may be:
- Anemic
- Less likely to get thorough prenatal care
- More likely to have premature labor or birth
- Unaware that they might have sexually transmitted infections (STIs)
What are the potential complications of a high-risk pregnancy?
A high-risk pregnancy can be life-threatening for the pregnant woman or her fetus. Serious complications may include:
- Preeclampsia (high blood pressure from pregnancy)
- Eclampsia (seizure from pregnancy)
- Preterm delivery
- Caesarean delivery (C-section)
- Excessive bleeding during labor and delivery, or after birth
- Low or high birth weight
- Birth defects
- Miscarriage
- Stillbirth
- Problems with fetal brain development
- Neonatal intensive care unit admission for your baby
- Intensive care unit admission for the mother-to-be.
How is a high-risk pregnancy diagnosed and monitored?
Getting early and thorough prenatal care is critical. It’s the best way to detect and diagnose a high-risk pregnancy. Be sure to tell your healthcare provider about your health history and any past pregnancies. If you do have a high-risk pregnancy, you may need special monitoring throughout your pregnancy.
Tests to monitor your health and the health of the fetus may include:
- Blood and urine testing to check for genetic conditions or certain congenital conditions (birth defects).
- Ultrasonography uses sound waves to create images of the fetus, to screen for congenital conditions.
- Monitoring to ensure that the fetus is getting enough oxygen, such as a biophysical profile, which monitors their breathing, movements and amniotic fluid using ultrasound, and a non-stress test, which monitors their heart rate.
Will my Prenatal Care be different with a High-Risk?
Generally speaking, a high-risk pregnancy will more than likely require more frequent prenatal visits and closer monitoring. If your condition is serious enough, you may even be referred to a Fetal Medicine Specialist for your care and treatment.
The exact care you will receive is dependent on your particular condition and circumstances. Your Fetal Medicine Specialist will more than likely continue to work with your ob-gyn, to ensure that both you and the baby are healthy as the pregnancy progresses.
Is my baby going to be okay?
It’s natural for a high-risk pregnancy to cause anxiety in the parents-to-be about the health and wellness of their baby. Good prenatal care makes it possible to have a healthy baby even if the pregnancy is high-risk.
Keep the lines of communication open with your doctor and talk to him/her about your concerns. Inquire if there is anything you can do to keep yourself and your baby as healthy as possible. This means discussing any drugs you may be taking and allowing your doctor to change your medications if they are not safe for the baby.
Note: Do not stop taking any medication without consulting your doctor.
If complications occur as a result of some drug interaction or a health problem, the results could be early childbirth, which could cause difficulty in breathing and feeding, not to mention a whole host of other complications. If this happens, the baby may have to spend more time in the hospital to stabilize and get well, in addition to requiring more care and attention. When this happens, newborn babies are often placed in the neonatal intensive care unit (NICU).
How can I prevent a high-risk pregnancy?
You can reduce your risk of pregnancy complications by:
- Avoiding drugs and alcohol
- Quitting smoking
- Maintaining a healthy body weight before pregnancy
- Managing any pre-existing health conditions, you may have.
- Planning pregnancies between the ages of 18 and 34
- Practicing safe sex
- Identifying potential health risks before getting pregnant.
- Telling your doctor about your family and personal medical history
- Make sure any long-term medications are safe to take during pregnancy.
