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.)
- 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.
For mothers who were diagnosed with preeclampsia for their first pregnancy, chances are they will be diagnosed again with their second pregnancy I’ve heard. What kind of blood pressure medications are safe when pregnant the second time (if your pressures are higher than normal), and what other precautions should the mother take? Has there been more information studied about genetic preeclampsia? Are there studies nationwide available to participate in for mothers who have had preeclampsia?
Hi Erica. If you have a history of preeclampsia, you are at an increased risk to have it again in another pregnancy. The earlier in pregnancy you had preeclampsia, the higher your risk is to have it again. You’re also at higher risk if you had preeclampsia along with other pregnancy complications. If your provider thinks you’re at risk of having preeclampsia, he may want to treat you with low-dose aspirin to help prevent it. Talk to your provider to see if treatment with aspirin is right for you. You can read more on our website: http://www.marchofdimes.org/complications/preeclampsia.aspx.
If you need medicine to control your blood pressure, your provider can help you choose one that’s safe for you and your baby. http://www.marchofdimes.org/complications/high-blood-pressure-during-pregnancy.aspx