Pregnancy sometimes raises women’s fear of being exposed to very dangerous situations, which may affect the mother and the child negatively.
“It is important to know that the majority of women have a successful pregnancy,” says Thaddeus Waters, M.D., maternal-fetal medicine specialist at Rush. “There may be challenges for some along the way, and may require additional evaluations and follow-up care, but even women with the most complex problems have healthy pregnancy and children.
Research shows that 8% of all pregnancies are high-risk. Here are five common health conditions that are often a factor in high-risk pregnancies and ways to manage them to ensure a successful pregnancy and delivery.
High blood sugar during pregnancy can increase a woman’s risk of developing type 2 diabetes or obesity, and it also increases the chance of a baby being delivered by caesarean section. There is also a higher risk of birth defects, premature birth, stillbirth and gigantism, a condition in which a baby is born much larger than usual.
To help manage diabetes during pregnancy, Waters stresses the importance of consulting a doctor as soon as you decide to become pregnant.
“Your doctor can help you control your blood sugar levels and make adjustments to your medications as needed. They can also check and treat other health-related complications due to diabetes, such as eye, heart or kidney disease, which may also affect pregnancy.”
Other best practices to consider before becoming pregnant include following a healthy meal plan, staying active, and taking insulin as directed by your doctor.
Overweight pregnant women tend to work longer, and their providers may have difficulty monitoring the baby during labour. This can increase the chance of having a cesarean delivery. Obesity during pregnancy can also lead to other health problems, including gestational diabetes, preeclampsia (high blood pressure during pregnancy) and sleep apnea.
Babies of pregnant women who are overweight can be at risk of birth defects, gigantism, premature birth and stillbirth.
Waters stresses that losing weight before pregnancy can help reduce the risk of problems caused by obesity.
“By getting regular exercise and working with a dietitian, you can help improve your overall health and pave the way for a healthier pregnancy,” he says.
The most common problem in women with high blood pressure is related to baby growth, or intrauterine growth restriction, which may contribute to an increased risk of stillbirth.
In addition, women with a history of high blood pressure are at greater risk of developing pre-eclampsia, a potentially dangerous condition that can lead to complications for both mother and baby. Studies show that preeclampsia occurs in about one in 25 pregnancies.
“Most women who are at risk for pre-eclampsia will not have a serious condition, but the unpredictability and fear of what could happen is a challenge,” says Waters. “Health providers can help manage high blood pressure and the problems associated with it.”
And if you’re pregnant and have high blood pressure, Waters notes that your care team will closely review and monitor your general health, including your history with high blood pressure and medications and other medical conditions, to help manage the effects.
Pregnancy that occurs at an advanced age can affect the health of the child, such as poor growth of the child and genetic problems, the most common of which is Down syndrome.
According to the American College of Obstetricians and Gynecologists, the risk of a pregnancy with Down syndrome is one in 353 for women who are 35 years old.
“As a woman gets older, the eggs she was born with also progress,” says Waters. “With each year, there is a slightly higher chance of a genetic problem in the baby. But there are ways to help assess this risk, such as working with a genetic counselor before planning a pregnancy.”
Women over age 35 are more likely to develop other pregnancy complications, such as gestational diabetes, high blood pressure or pre-eclampsia. For women under 35, there can be a chance of a high-risk pregnancy, but Waters says that depends on each woman’s distinct risk factors.
“Even if the mother does not have any related problems or history, there is still a small risk that the baby will have a genetic problem, an underlying structural problem, or any other concern with the baby that could increase the risk of pregnancy,” he added.
There was a common misconception in the past that women with epilepsy could not have a healthy pregnancy because it would be too risky. “This is simply not true in this day and age,” says Adriana Permo Oval, a neurologist at Rush, which specializes in the care of women with epilepsy.
In fact, according to the Epilepsy Foundation, more than 90% of women with epilepsy carry healthy babies.
Another concern for women with epilepsy is the control of seizures during pregnancy, which can cause risks to the baby, such as acute shock, hypoxemia (low blood oxygen level), fetal injury, intrauterine growth, premature birth and possible pregnancy loss.
However, recent research shows that with proper prenatal care for epilepsy, there is no increased risk of seizures during pregnancy or the immediate postpartum period.