In a high risk pregnancy, the pregnant person or the fetus has certain risk factors that could increase the chances of complications such as an early birth.
The term “high risk pregnancy” can cause anxiety. However, having one or more risk factors does not guarantee that complications will occur, and some risk factors are treatable.
It is important to keep in contact with doctors and attend regular checkups during pregnancy.
Read on to learn more about what makes a pregnancy high risk, how doctors manage high risk pregnancies, and more.
Healthcare professionals consider a pregnancy high risk if a pregnant person or their fetus has certain risk factors for complications during pregnancy or birth.
These factors may increase the chances of complications such as high blood pressure and preterm birth.
However, the exact risks and degree of risk will vary from person to person. The term “high risk pregnancy” is not precise and does not guarantee that complications will happen.
Some people with high risk have typical pregnancies and births. In other cases, some factors
Many factors can contribute to high risk pregnancy status. A person may be able to change some of these factors but not others.
Pregnancy factors
Sometimes, the features of a pregnancy itself increase the risk of complications. Examples include:
- Multiple gestation: Pregnancies with multiple fetuses — such as twins or triplets — are more likely to lead to preterm birth, and the babies may be smaller.
- Gestational diabetes: This condition occurs when a person develops diabetes during pregnancy despite not having it before. Gestational diabetes increases the risk of several complications, but it is manageable with help from a doctor.
- Preeclampsia and eclampsia: Preeclampsia is a sudden increase in blood pressure. It can affect the kidneys, liver, or brain. Eclampsia is a more severe form and can cause seizures or coma. However, there are ways to manage preeclampsia with medical care.
- Previous preterm birth: People who have previously given birth early, before
37 weeksTrusted Source , are at a higher risk of having another preterm birth. - Placental or fetal position: Sometimes, the placenta’s position makes a pregnancy or birth more complex. In a condition known as placenta previa, the placenta can develop over or near the cervix. Similarly, if a fetus is breech or in another difficult position, the birth may have a higher risk of complications.
- Fetal genetic conditions or differences: Sometimes doctors detect certain conditions in a fetus before birth. A pregnancy may be considered high risk if the fetus will need medical treatments during pregnancy or immediately after birth — for example, some types of spina bifida are repairable via treatment in the uterus.
Age
The pregnant person’s age can play a role in their risk of certain complications. For example, teenagers who become pregnant are more likely to:
- develop high blood pressure
- develop anemia, which is a decrease in red blood cells
- have a preterm birth
Teens may also be at risk of missing out on medical care if they conceal the pregnancy or cannot access healthcare, which could pose a risk to them or to the fetus.
Additionally, there are associations between older age and pregnancy complications. People over 35 years of age who become pregnant for the first time are more likely to:
- develop high blood pressure
- develop gestational diabetes
- have a child with certain genetic conditions
- have an ectopic pregnancy, in which the embryo attaches outside the uterus
- have a long labor of
more than 20 hoursTrusted Source - have a labor that does not advance
- need a cesarean delivery
- experience delivery complications such as bleeding
Preexisting conditions
Certain preexisting health conditions may increase a person’s risk of pregnancy or birth complications. Examples include:
Polycystic ovary syndrome (PCOS)
People with PCOS have a higher risk of pregnancy loss before the
High blood pressure
Slightly high blood pressure does not always pose a significant risk in pregnancy, but uncontrolled high blood pressure can. It may increase the risk of a low birth weight or preeclampsia.
Diabetes
Unmanaged high blood sugar levels can affect the development of a fetus early in pregnancy. Babies born to a person with diabetes may be larger, which can affect delivery, and may have low blood sugar after birth.
Thyroid disease
If a person has an overactive or underactive thyroid and does not receive treatment, either condition may affect their pregnancy. These conditions also have associations with low weight gain, heart failure, and changes in brain development.
Thyroid disease is treatable with medications or surgery.
Autoimmune disorders
Some autoimmune conditions, such as lupus and multiple sclerosis, can increase the risk of some complications, although this can vary by condition. Some people find that their symptoms improve during pregnancy, but others may find that their symptoms flare up.
People with autoimmune disorders may also take medications that could affect the fetus.
Kidney disease
People with mild kidney disease may have no complications during pregnancy, but those with more advanced disease may have a higher risk of preeclampsia, low birth weight, or preterm delivery.
Kidney disease may also make it difficult for a person to become pregnant and stay pregnant.
Some infections
Some bacterial or viral infections can pose a risk to the fetus or the pregnant person or may pass to the fetus and cause problems later in life. Examples include the Zika virus, HIV, herpes, and other sexually transmitted infections.
Underweight or obesity
A person with a low or high body weight could have a higher risk of pregnancy complications.
Low body weight can
Obesity has associations with high blood pressure, gestational diabetes, intrauterine growth restriction, preeclampsia, and pregnancy loss.
Substance exposure
Substances that can affect the development of a fetus and the health of the pregnant person
- Tobacco: Smoking during pregnancy has links to preterm birth, certain differences in fetal development, pregnancy loss, and sudden infant death syndrome (SIDS).
- Alcohol: Alcohol consumption during pregnancy can raise the risk of preterm birth, pregnancy loss, and SIDS and can lead to fetal alcohol spectrum disorders (FASDs), a group of conditions that affect children in the long term. Symptoms of FASDs can include facial differences, learning disabilities, behavioral problems, and heart disorders.
- Drugs: Various drugs, including cannabis and some prescription medications, can affect the growth of a fetus and raise the risk of complications such as preterm birth.
Exposure to mercury can also affect a pregnancy. Mercury is present in many types of fish.
There are ways that healthcare professionals and pregnant people can reduce some of the risks involved in a high risk pregnancy. The medical team’s recommendations will depend on the situation but may involve:
- more frequent checkups
- at-home blood pressure or blood sugar monitoring
- medications to manage blood pressure or blood sugar
- treatments for infections
- treatment for preexisting conditions, such as thyroid disease
- a weight management plan
- support in reducing or stopping the use of alcohol or drugs
In some cases, doctors may also advise that a person make changes to their birth plan, such as giving birth in a hospital. This will ensure that a person has quick access to specialized care in the case of complex medical needs.
For some complications, a planned cesarean delivery may be necessary. For example, this may be the case if a person has preeclampsia.
People with any concerns about health risks during pregnancy should speak with a doctor.
Seek immediate help if a pregnant person develops
- high blood pressure
- a persistent headache that keeps getting worse
- dizziness or fainting
- significant swelling in the hands or face
- vision changes
- severe nausea and vomiting
- fever
- swelling and pain in the legs
- difficulty breathing
- rapid heartbeat
- chest pain
- a slowing or stopping of fetal movement
- vaginal bleeding or leaking fluid
- severe belly pain
The term “high risk pregnancy” means that a pregnant person or a fetus has one or more risk factors for pregnancy or birth complications.
Doctors may consider many factors to be high risk, such as a pregnant person’s age, preexisting conditions, and substance exposure.
However, high risk pregnancies do not always lead to complications, and the exact risk will vary for each person. For more insights into the risks and any potential treatments, speak with a doctor.
