News Moms Need

May was Preeclampsia Awareness Month. We blogged about the signs, symptoms and causes of preeclampsia and how it may lead to premature birth. We also hosted a Twitter chat with Dr. Kjersti Aagaard of Texas Children’s Pavilion for Women, which generated some follow-up questions.

We’re happy to welcome back Dr. Aagaard and her colleague Dr. Martha Rac as guest bloggers. Both doctors are maternal-fetal medicine specialists at Texas Children’s. They will share some insight into who is most at risk of developing preeclampsia and how it can impact both mom and baby.

First, we must ask, who is at the highest risk for developing preeclampsia?

 Risk factors for preeclampsia include:

• First time mothers
• Pregnancy with a new partner than previous pregnancies – different partners may have varying genetic factors that may increase preeclampsia risk
• Older mothers (>35 years old)
• Black women
• Medical problems including chronic high blood pressure, kidney disease, lupus, diabetes and heart disease
• Pregnancies with multiples (twins, triplets, etc.)
• Obesity
• Preeclampsia in prior pregnancies
• IVF pregnancies – particularly those with donor eggs. This is thought to occur as a result of genetic differences between the mother and fetus, causing the mother’s immune system to attack the “foreign” fetal tissue and cause excess inflammation.

In addition to the risk factors above, mothers with pregnancies spaced too closely together or very far apart can be at risk. Too close may be defined as 18 months or less and far apart as 4-5 years between pregnancies.

How does preeclampsia affect pregnancy?

Preeclampsia is classified as either mild or severe based on a woman’s symptoms, and how severely it affects her organs. It is a progressive disorder, which means that mild cases will eventually develop into severe preeclampsia, if not treated.

Preeclampsia can be very dangerous to both the mother and the baby. The very high blood pressure associated with preeclampsia can result in anything from seizures, stroke, liver and kidney dysfunction, bleeding problems, placental detachment and even death if left untreated.

If a mother-to-be suspects she may be experiencing preeclampsia, she should contact her doctor immediately.

How does preeclampsia impact the baby?

 This dangerous disorder can cause the baby’s growth to be restricted and increases the risk of stillbirth. In the most severe cases, preterm delivery may be required which may then expose the baby to the complications of prematurity such as under-developed organs, breathing difficulties, jaundice, anemia, a lowered immune system, etc.

In the worst cases, fetal death can occur from a sudden detachment of the placenta from the uterus.

For these reasons, women diagnosed with preeclampsia undergo additional monitoring such as: ultrasounds every 4 weeks to evaluate fetal growth, lab work to determine if there is multi-organ involvement, etc. and delivery no later than 37 weeks.

If you are worried you are at risk of developing this dangerous disorder, please be sure to consult with your doctor and discuss your concerns immediately.

Many thanks to Dr. Aagaard  (left) and Dr. Rac  (right) for contributing their expertise. 

Although there are certain risk factors for premature birth that a woman is not able to change, the good news is that there are three risk factors that most women can do something about.

Researchers at the March of Dimes Ohio Collaborative Prematurity Research Center are making big strides. According to their published study, up to one-quarter of preterm births (before 37 weeks of pregnancy) might be prevented if we focused on three risk factors – birth spacing, weight before pregnancy and weight gain during pregnancy.

What did the research show?

The study looked at the records of 400,000 single births and found that more than 90% of the women had one of these three risk factors. The women in the study who had less than a year between pregnancies, were underweight before pregnancy and gained too little weight during pregnancy had the highest rates of preterm births – 25.2%, according to the researchers. The good news is that women may have more control over these risk factors than other factors, which can influence preterm births.

Birth spacing

Birth spacing is the period of time between giving birth and getting pregnant again. It’s also called pregnancy spacing or interpregnancy interval (also called IPI). Getting pregnant too soon can increase your next baby’s chances of being born prematurely, as well as being born at a low birthweight or small for gestational age (SGA). It’s best to wait at least 18 months after having a baby before getting pregnant again. If you’re older than 35 or have had a miscarriage or stillbirth, talk to your provider about how long to wait.

Weight before pregnancy

Getting to a healthy weight before pregnancy is important. Women who are overweight or underweight are more likely to have serious pregnancy complications, including giving birth prematurely. How do you know if you’re at a healthy weight? Schedule a preconception checkup with your health care provider. This is the best time to discuss your weight and make sure you’re healthy when you get pregnant.

Weight gain during pregnancy

Gaining too much or too little weight can be harmful to you and your baby. It’s important to gain the right amount of weight for your body. Your provider can help you determine how much weight you need to gain during pregnancy.

Bottom line

There is still much we do not know about the causes of premature birth. But, knowing some things that a woman can do to decrease her chance of giving birth early, is good news.

Check out the cutting edge research our Ohio Collaborative is working on.

Recently I had an appointment with a new healthcare provider and had to complete a health history form at my first visit. It was 3 pages long and took me about 20 minutes to do while in the waiting room. As I was sitting there, I realized that I didn’t know the answers to some of the questions, especially about my relatives.

Was this really that important?

In one word? Yes.

A family health history (FHH) form is a record of health conditions and treatments that you, your sisters, brothers, parents, aunts, uncles, grandparents and great grandparents have had. It can help you figure out the medical problems that run in your family. Knowing your FHH may just save your life. It may also have a direct effect on your baby’s health.

How can a FHH form help your baby?

The FHH form will help your provider see if any of the conditions or diseases that run in your family will affect your baby. For example, premature birth can run in families. And, certain conditions such as diabetes or high blood pressure put you at a higher risk to have a premature baby.

If you and your partner complete a FHH form and share it with your prenatal provider, you may learn about the health of your baby before she is born. The earlier in your pregnancy that your provider is aware of health conditions, the sooner your provider can decide on treatments for you.

It would be even better if you could complete and share this information with your provider before pregnancy, at a preconception checkup. This way, your provider can help you become as healthy as possible before pregnancy.

Use our FHH form

Here is a form that you can print out and complete.  Print one copy for yourself and one for your partner/spouse. We suggest you take it with you to family gatherings (Thanksgiving anyone?) and ask your relatives to help you fill in the blanks. You may very well find out information about diseases and conditions that run in your family and put you at risk. Early detection is often key in successfully managing a disease.

Here are tips on how to gather information from relatives.

Knowing your risk for certain conditions and that your provider is on top of treatment options, should put your mind at rest. And, knowing you are doing your best to take care of your baby’s health should make you feel even better.

So, when you sit down to apple pie, start a conversation, and fill in your FHH form. The information you share with your family may make a positive difference in everyone’s lives.

Have questions? Text or email us at AskUs@marchofdimes.org.