The classification of a pregnancy as “high-risk” can stem from a variety of factors. These can range from pre-existing health conditions, lifestyle choices and fetal well-being concerns to experiences of recurrent pregnancy loss and advanced maternal age.
By recognizing and understanding the individualized nature of these considerations, we can proactively navigate this chapter of your pregnancy with informed decision-making and tailored support.
“Managing a high-risk pregnancy appropriately is important for the health of Mom and the baby,” says Dr. Curtis Elam, a board-certified physician with Beaufort Memorial Obstetrics & Gynecology Specialists. “If your pregnancy requires more monitoring or specialized care, ‘high-risk’ isn’t a negative. It’s intended to ensure your pregnancy has the best possible outcome.”
Read More: Your Pregnancy Journey: Rules of the Road
High-Risk Factors
A high-risk pregnancy can be identified before pregnancy or during your pregnancy. Some issues that put a pregnancy in the high-risk category occur before your pregnancy. Other conditions happen during pregnancy or as a result of it – either affecting you or your baby – and require close, special attention to be sure mother and baby are OK.
Pre-existing conditions that can make a pregnancy high-risk include:
- Autoimmune disorders such as multiple sclerosis or lupus can increase your risk for complications, and some medications to manage your symptoms can be harmful to your baby.
- Diabetes can cause congenital anomalies even before you know you’re pregnant because of high blood sugar levels. In addition, throughout your pregnancy, your blood sugar may significantly increase or decrease, and it needs to be monitored carefully.
- High blood pressure can increase the risk for preeclampsia or low birth weight if your blood pressure is high and goes unchecked.
- Obesity can increase the risk of sleep disorders like sleep apnea during pregnancy, makes it more likely you’ll develop diabetes while pregnant, and has been tied to structural concerns with a baby’s heart. If you have been diagnosed with obesity, it’s important not to gain too much weight during pregnancy. Working with your OBGYN and/or high-risk practitioner can help you make the right dietary decisions.
- Thyroid disease, whether caused by an underactive or overactive thyroid gland, can cause brain development issues, heart failure and low birth weight. If you have a thyroid condition and it’s not under control, work with your primary care provider before pregnancy if possible.
A high-risk pregnancy might require special care outside of the standard prenatal care process, with more visits to your OBGYN. If your OBGYN thinks it’s necessary, they will refer you to a maternal-fetal medicine provider, who specializes in high-risk pregnancies.
“Keeping up with prenatal visits is vital to a healthy pregnancy if you have a pre-existing condition,” Dr. Elam says. “It can mean the difference between a full-term pregnancy and a preterm birth.”
Read More: Pregnancy Complications All Black Women Should Know About
High-Risk Complications During Pregnancy
You can develop certain conditions during pregnancy. Maintain prenatal appointments with your OBGYN in case any new health concerns need to be addressed. Treatment of health problems that occur during pregnancy helps support your health and your baby’s health. Conditions that can occur during pregnancy include:
- Congenital anomalies or genetic conditions in the fetus can be found by your OBGYN or high-risk specialist during pregnancy. Some issues require treatment before birth and some should be addressed right after birth.
- Gestational diabetes can occur during pregnancy, even if you've never been diagnosed with diabetes. If you have gestational diabetes, it’s crucial to work closely with your OBGYN or high-risk specialist to make sure it’s under control.
- Multiples, or multiple gestation, refers to pregnancy with twins, triplets or more, and it can increase the risk of premature birth, defined as any time before 37 weeks. Babies may also be smaller than average if you’re pregnant with multiples.
- Preeclampsia develops after 20 weeks of pregnancy and is diagnosed when a woman’s blood pressure spikes without warning. If left untreated, these conditions can evolve into eclampsia, a more serious form of preeclampsia. Either of these conditions can cause permanent brain, kidney or liver damage. Additionally, a significant number of women who are diagnosed with preeclampsia during the early stages of pregnancy also have kidney disease that had not been previously identified.
- Preterm birth is more likely if you’ve had a preterm birth in the past. If you’ve had a baby prior to 37 weeks in the past, you’re more likely to have a preterm baby again, and a high-risk specialist may be the best choice to monitor your pregnancy.
Read More: Gestational Diabetes
Pregnancy After 35
Age can be a factor in determining whether a pregnancy is high-risk. It's worth noting that more and more women are choosing to embark on the journey of pregnancy after the age of 35. Studies show that if you’re over the age of 35 and you’re pregnant for the first time, you can still have a completely healthy pregnancy.
However, after age 35, you’re at higher risk for some of the complications that can occur with any pregnancy, including:
- Complications with delivery
- Down syndrome in the baby
- Ectopic pregnancy
- Gestational diabetes
- Gestational high blood pressure
- Pregnancy loss
- Slow or non-advancing labor
“If you’re over the age of 35, the risks are simply amplified,” Dr. Elam says. “Talk to your OBGYN before you get pregnant, if at all possible, so we can help throughout every step of your pregnancy.”
The term “high-risk” may initially seem alarming, but it is important to remember that it signifies the need for specialized health care to ensure the well-being of both you and your baby.
If you have been identified as high-risk and feel anxious about the next steps, it can be valuable to confide in friends and family who may have shared a similar journey and can provide understanding and support. Additionally, remember the significance of maintaining regular communication with your OBGYN and pregnancy care team throughout this process to receive proper guidance and care tailored to your specific needs.
Request an OBGYN appointment, or register for a free Baby University class.
