A wide range of issues cause high-risk pregnancies, which could result in health problems for both mom and baby. However, if handled correctly, the chances of a healthy pregnancy and healthy child will increase. UnityPoint Health, maternal-fetal medicine specialist, Alfred Fleming, M.D., explains what all women should consider before conception.
What is a High-Risk Pregnancy?
High-risk pregnancy is simply a pregnancy where there could be potential complications for both mom and baby. Dr. Fleming says there are several situations that would cause a pregnancy to fall in this category, with some common problems being diabetes, high blood pressure and obesity.
“Oftentimes, it depends on the severity of the situation and if there are other complications involved, say with the kidneys, for example,” Dr. Fleming says. “When a patient has these pre-existing conditions, it’s not black or white.”
Dr. Fleming says being overweight is a significant problem in this country. He says the sedentary nature of our society leads to more obesity, which in turn, leads to higher rates of diabetes, high blood pressure, and other pregnancy complications like fetal growth disturbances.
“Being significantly overweight, in addition to diabetes and high blood pressure, can also be associated with other devastating pregnancy complications like birth defects, blood clots and stillbirth. It can also cause infertility. Ovulation becomes more of an issue if you are overweight because of an imbalance of hormones like estrogen,” Dr. Fleming says.
Women can also be added to the high risk category, if they are considered advanced maternal age, which is defined as having children at the age of 35 or older. For this age group, there is a better chance the mother will develop complications, including gestational diabetes and high blood pressure. However, Dr. Fleming says issues surrounding advanced maternal age are more of a concern for women age 40 and above.
“Those who are age 35 have a one in 270 risk for having a child with Down syndrome. For each year, the risk increases, and by the age of 40, it’s one in 82,” Dr. Fleming says.
Getting older isn’t just a concern for females. Dr. Fleming says as men age, there is an increased chance of spontaneous mutations in babies, which are not chromosomal in nature. Despite the risks, many couples are opting to have children later in life. According to the Centers for Disease Control (CDC), from 2000 to 2014, the proportion of first births to women age 35 and over rose 23 percent.
“Women are in careers, and people are getting married and having children later in life, that just seems to be a trend. I have worked with patients who are having babies during second marriages,” Dr. Fleming says.
Considering a Preconception Consultation
Dr. Fleming says if you are considered high risk, you should have a preconception consultation. He adds it’s not a bad idea for any woman, regardless of age or health, to have one of these talks with her provider.
“A consultation can help women gain control of certain diseases to increase chances of a healthy pregnancy. For example, if a woman with high blood pressure wants to have a child, she should only be on certain blood pressure medications. Some blood pressure medications should not be used during pregnancy because of they are known to be associated with birth defects. A meeting with your provider could help identify those issues and prevent a possible negative outcome on the baby. It can also help women who don’t have an identified disease, identify if they are carriers for certain genetic disorders they may pass to their offspring.” Dr. Fleming says.
A consultation can help ensure a woman has good control of her overall health, which helps create a healthy environment for a baby. It’s different for every patient, but Dr. Flemings says just having a few months of control of your disease could greatly improve the chances of a healthy pregnancy.
When Pregnancy is Too Risky
While Dr. Fleming helps most patients work toward parenthood, there is a subset of health concerns in which he steers patients away from pregnancy.
“I advise patients who have an artificial heart valve away from pregnancy, because they are at an increased risk for stroke while pregnant. Based on high mortality risks, it’s also a good idea for women with pulmonary hypertension to avoid becoming pregnant,” Dr. Fleming says.
Regardless of your medical history, it’s a good idea to talk to your UnityPoint Health provider to identity any risk, before conception.