Are You at Risk for Preeclampsia?

By Jill Ross, HealthAtoZ contributing writer

You've heard high blood pressure can be bad for your heart. But if you're thinking of getting pregnant, you should also know that hypertension can be one of the most serious threats to pregnant women and their babies. High blood pressure may be pre-existing and worsen during pregnancy and could be a risk factor for development of superimposed preeclampsia. High blood pressure during pregnancy can result in a disorder called preeclampsia, which typically develops after the 20th week. Preeclampsia, also known as toxemia, is the leading cause of both maternal and fetal death, and it contributes significantly to premature birth, low birth weight and other complications related to pregnancy, according to the National Heart, Lung and Blood Institute.

Preeclampsia is on the rise in the United States because more women are having children later in life and having multiple births - two factors that increase the likelihood of developing this disorder.

If you are over 35 or have a multiple pregnancy, you are more likely to develop preeclampsia and should be monitored more closely during pregnancy.

Blood pressure, age and fertility drugs are factors

Older women are more likely to have underlying hypertension, which puts them at an increased risk for preeclampsia. Fertility drugs also result in more multiple births, which has long been known as a risk factor for preeclampsia.

The number of children born to women in their late 30s is steadily increasing, and women 45 years and older still have birthrates of 0.5 children per 1000 women, according to the National Center for Health Statistics (NCHS). NCHS reports that the rate of twin births has risen 70 percent since 1980 to 32.3 per 1000 births in 2004.

As a result of those trends, the number of preeclampsia cases has risen in the past 10 years by nearly one-third in the United States. There were more than 168,000 cases of preeclampsia and other blood pressure disorders in 2002.

If you have preeclampsia, your blood pressure is elevated and protein is abnormally excreted in your urine. The effects of the high blood pressure range from mild to severe. It can harm the mother's kidneys and other organs, and it can cause low birth weight and early delivery. The only way to cure preeclampsia is to deliver the baby.

Women who are more likely to develop preeclampsia are those who:

• Have chronic hypertension (high blood pressure before becoming pregnant)
• Developed high blood pressure or preeclampsia during a previous pregnancy, especially if these conditions occurred early in the pregnancy
• Are younger than 20 or older than 35
• Are pregnant with more than one baby
• Have diabetes, kidney disease, rheumatoid arthritis, lupus or scleroderma.

Symptoms and diagnosis

There is no single test to predict or diagnose preeclampsia. The key signs of preeclampsia are an increase in blood pressure and protein in the urine. Other symptoms include persistent headaches, blurred vision or sensitivity to light and abdominal pain.

The best approach is to be proactive and talk to your doctor or nurse first if you are thinking about having a baby and have high blood pressure or other risk factors. The important thing is a preconception consultation with an obstetrician, getting medications, lifestyle and general health in order.

Taking steps to control your blood pressure before and during pregnancy and getting regular prenatal care can go a long way toward ensuring a good outcome for mother and child. So, for those who have risk factors for preeclampsia, we offer the following tips endorsed by the National High Blood Pressure Education Program:

• Shed those extra pounds before you get pregnant. Don't lose weight during pregnancy and you can't exercise aggressively during pregnancy.

• Avoid alcohol and tobacco.
  
  
• Ask your doctor about your blood pressure medicines. If you are taking such medicines, ask your doctor if the medications you are on are safe during pregnancy, whether you should change the amount you take, whether you need to change the type of medication you take or if you can stop taking them during pregnancy. There are two specific classes of blood pressure medications that should best be avoided - angiotensin-converting enzyme (ACE) inhibitors and angiotensin II (AII) receptor antagonists.

• Get regular prenatal medical care so your condition can be monitored.

If you develop preeclampsia in your first pregnancy, will you likely get it again in subsequent pregnancies? Not necessarily (the risk is 25 percent) unless there are factors that put you at risk in the first place. For example, an older mom or someone taking blood pressure medications would still be at risk.

Related Articles What Is Preeclampsia? Who Is at Risk for Developing Preeclampsia?

External Sources National Center for Health Statistics. Births/Natality. Accessed May 17, 2007. National Heart, Lung and Blood Institute. Working Group Report on High Blood Pressure in Pregnancy. Accessed May 17, 2007.

This article was reviewed and updated June 2007.

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