Preeclampsia is a pregnancy complication characterized by high blood pressure and signs of damage to other organ systems, most often the liver and kidneys. It begins after 20 weeks of pregnancy in individuals whose blood pressure had previously been in the standard range. While many people have no noticeable symptoms, the initial signs are detected during routine prenatal visits. Left untreated, preeclampsia can lead to serious complications for both the parent and baby.
Pre-Existing Medical Conditions
Certain health conditions present before pregnancy can increase the likelihood of developing preeclampsia. These conditions often place underlying stress on the cardiovascular system, which is then amplified by the physiological demands of pregnancy.
Chronic hypertension, or high blood pressure that exists before pregnancy or develops before 20 weeks of gestation, is a risk factor. The vascular system is already under strain, and the increased blood volume and cardiac output of pregnancy can exacerbate this. Women with pre-existing hypertension are more likely to develop preeclampsia compared to those with normal blood pressure.
Kidney disease is another predisposing factor. The kidneys play a part in blood pressure regulation, and impaired kidney function before pregnancy means the organs may struggle to handle the increased workload. This can lead to the protein in the urine (proteinuria) and elevated blood pressure characteristic of preeclampsia.
Conditions like Type 1 and Type 2 diabetes also elevate the risk. Diabetes can affect the health of blood vessels throughout the body. High blood sugar levels can damage small blood vessels, including those that supply the placenta, potentially leading to placental problems.
Autoimmune diseases, such as lupus and antiphospholipid syndrome, are linked to a higher incidence of preeclampsia. These conditions involve systemic inflammation and can affect blood vessels and organ function, which can interfere with normal placental development.
Pregnancy-Specific Characteristics
Some risk factors for preeclampsia are not related to a person’s health history but are features of the pregnancy itself. A prior history of preeclampsia is one of the strongest predictors, as a person who has had it before has a markedly higher chance of developing it again.
The number of babies being carried also plays a role. Pregnancies with multiples, such as twins or triplets, are associated with a greater risk. This is thought to be related to the increased placental mass and the higher levels of pregnancy-related hormones, which place a greater demand on the maternal cardiovascular system.
A first-time pregnancy, medically termed nulliparity, is another established risk factor. The body’s initial adaptation to the immunological and vascular changes of pregnancy may be less efficient the first time around.
Conception through in vitro fertilization (IVF) has also been identified as a risk factor. The reasons for this association are still being studied but may relate to the underlying causes of infertility or specific aspects of the IVF process itself.
Personal and Genetic Factors
A person’s individual characteristics and genetic background also contribute to their overall risk profile for preeclampsia.
Maternal age is a recognized factor, with risk being higher for those at either end of the reproductive spectrum. Individuals over the age of 35 or 40, as well as those in their teenage years, show a higher incidence of the condition. This suggests that both very young and advanced maternal ages can influence the body’s ability to adapt to pregnancy.
Obesity, defined by a body mass index (BMI) of 30 or higher before pregnancy, is a strong risk factor. Excess weight is associated with underlying inflammation and metabolic stress, which can negatively impact vascular health and placental development, setting the stage for preeclampsia.
A family history of preeclampsia, such as a mother or sister having had the condition, points to a genetic predisposition. Research has identified several genetic locations that influence an individual’s risk, suggesting that inherited factors play a part in the complex development of the disorder. This familial link underscores that risk is not solely based on individual health choices or conditions. Black individuals also experience a higher risk, a complex issue tied to a combination of health disparities and potential genetic predispositions.
Addressing Preeclampsia Risks
Identifying an individual as high-risk for preeclampsia allows for proactive steps to be taken throughout the pregnancy. The goal is to monitor for early signs of the condition and, in some cases, to implement preventive measures.
Early and consistent prenatal care is important for anyone at increased risk. Regular appointments allow for frequent monitoring of blood pressure and urine protein levels, the primary indicators used to detect preeclampsia. These checks can catch the condition before more severe symptoms develop.
For certain high-risk individuals, healthcare providers may recommend a daily low-dose aspirin regimen. This therapy is started after 12 weeks of pregnancy and is thought to work by improving blood flow in the placenta and reducing inflammation. This treatment should only be initiated and managed under the guidance of a healthcare professional.
Open communication with a healthcare provider is important for managing risk. Discussing personal and family medical history helps to accurately assess risk levels from the outset. Recognizing and promptly reporting potential warning signs, such as swelling in the hands and face, severe headaches, or vision problems, allows for timely intervention and management.