Elevate Your Health Colorado High-risk pregnancy: Could you be at risk?

Pregnancy is one of the most joyous times in a woman’s life. Ideally, a woman goes into labor close to her due date, delivers a healthy baby, and returns home within a few days. In reality, pregnancies can be complex – especially when they are considered high-risk. The good news, however, is that most of these concerns can be alleviated through planning, preventive steps and ongoing communication with your doctor.

According to Sharman Reed, MD, board-certified Ob/Gyn with Kaiser Permanente Colorado, a pregnancy is considered high-risk when there are potential complications that could affect the mother, baby, or both. Below, she outlines the most common risk factors for a high-risk pregnancy, and how you can manage them. 

• Being older than age 35. Women who become pregnant after age 35 have a higher risk for miscarriage and delivering a baby with genetic defects, such as Down Syndrome. Although these factors can be scary, many women in their late 30s and early 40s go on to have healthy pregnancies. The key is discussing the appropriate screenings with your Ob/Gyn to check for genetic defects.
   
• Living with a pre-existing medical condition. A mother’s health prior to conceiving is almost equally as important as it is during pregnancy. Complications such as asthma, heart disease, blood-clotting disorders, or other chronic infections or diseases present risks for the mother and baby. “The two most common chronic conditions are hypertension and diabetes,” Dr. Reed says.

  Make sure any conditions are controlled with a healthy lifestyle, and make sure to discuss your health and any medications you take with your doctor. Mothers-to-be should not stop medications that help manage pre-existing conditions during pregnancy. 

   

• Developing medical complications during pregnancy. Even the healthiest of moms can develop medical conditions during pregnancy that could lead to pre-term delivery. Pregnant women should be monitored closely for complications and treated appropriately. Two common pregnancy-induced conditions your doctor will screen for are:
  • Preeclampsia – This is a blood circulation problem that causes high blood pressure, urinary protein, and swelling, which places strain on the mother's kidneys, liver, brain, and placenta.
     
  • Gestational diabetes – Pregnant women can develop diabetes when the pancreas does not produce enough insulin to keep blood sugar levels in a healthy range. If left unmanaged, high blood sugars can cause the baby to grow too large, and damage the mother’s organs. Although the condition typically resolves itself after delivery, women with gestational diabetes are at a greater risk for developing type 2 diabetes.
     
• Being overweight and excessive pregnancy weight gain. “Ideally, women should work with their doctors to reach an ideal weight for their body type before becoming pregnant,” Dr. Reed says. “Pregnant women who are obese typically already suffer from conditions like diabetes or hypertension.” Excess weight can also make it difficult for physicians to monitor the baby’s growth during pregnancy, and can present health problems for the child later in life. 

  And remember, pregnancy is not a license to eat in excess or become sedentary. A Kaiser Permanente study suggests women who gain excessive weight during their first trimester may increase their risk of developing gestational diabetes, and their child’s risk of developing diabetes and obesity later in life. To determine how much weight gain is healthy, your Ob/Gyn will consider your pre-pregnancy weight and body mass index (BMI). 

  Creating a safe exercise plan and developing healthy menu options with your physician will not only help you maintain a healthy weight during pregnancy, but also after the baby is born. 

Care for you and your baby

The improvement of your overall health can be a by-product of monitoring a high-risk pregnancy.  “In many cases, we handle a patient’s chronic conditions as well as their maternal care,” Dr. Reed says. “We track medications, blood pressure, blood sugar levels, and the overall health of the mother and the baby.”

If your pregnancy is considered high risk, your doctor may refer you to a perinatologist – an obstetrician who specializes in high-risk pregnancy care. To improve communication between your care team, Kaiser Permanente uses an electronic medical record system, which allows a woman’s care providers to share her medical history, track medication changes, and send instructions for follow-up care. “We can also send results and communicate with the mother-to-be through secure e-mail,” Dr. Reed notes.

Find more tips to manage a high-risk pregnancy, as well as prenatal classes and programs at kp.org.