Every pregnancy may carry some risk. A pregnancy is considered to be high risk when the risk of complications for the mother, baby or for both, are higher than normal. High risk pregnancies require special care in Centers that are equipped to handle these deliveries, under an Obstetrician who is experienced in handling them, to ensure the best outcomes for mother and baby.
These are five risk factors that every woman should be aware of before her pregnancy.
- The Age Factor:
Risks are higher during pregnancy when the age of the mother is less than 20 or greater than 35. Teenage pregnancies are associated with an increased incidence of anaemia in the mother, high blood pressure and preterm labour. There may be risks associated with an underdeveloped pelvis in the mother that may require a Caesarian section.
For women older than 35, the risks of developing high blood pressure and gestational diabetes are increased. These mothers are more likely to deliver a low birth weight baby and have a premature birth. The risks of having a placenta praevia are higher requiring a Caesarian section. The chances of chromosomal abnormalities in the baby are also increased and there is greater pregnancy loss through miscarriage or still birth
- The weight factor
Women who are either underweight or overweight face the risk of complications during pregnancy.
For obese women, the risks during pregnancy include the risks of developing preeclampsia, gestational diabetes, urinary tract infections and post-partum infections. Pregnancy may continue past the due date. Labour induction is more difficult in the obese and administration of pain relief measures such as an epidural is more difficult. There is an increased risk of miscarriage in the obese. Babies are usually larger, with more fat, and have a greater risk of developing childhood obesity and diabetes as an adult. There is also a risk that the baby may have a birth defect.
For underweight women, with a BMI < 18.5, the risks of miscarriage in the first trimester are higher. It also increases the risk of a premature birth and having a baby who is underweight.
- Underlying conditions such as diabetes, hypertension, epilepsy, anemia and infection including sexually transmitted infection can increase pregnancy risks. A past history of a Caeserian section, low birth weight baby, preterm birth or pregnancy loss or death of a baby shortly after birth might increase the risk in subsequent pregnancies.
During pregnancy, the placenta, produces high levels of various hormones, almost all of which impair the action of insulin in the cells, raising blood glucose levels. In patients with pre-existing diabetes, this makes the control of diabetes more difficult. Patients who had normal blood sugars before pregnancy, may develop raised blood sugar levels, a condition known as Gestational Diabetes Mellitus.
Patients with both type 1 and type 2 diabetes carry the risks of complications during pregnancy. High glucose levels in the blood can be unhealthy for both the mother and the baby. There are risks of having an extra large baby with the resultant problems during delivery for both the mother and the baby and the risks of requiring a Caeserian section.
Women with diabetes have high blood pressure more often than women without diabetes. This may cause a premature birth or it may cause convulsions or stroke in the mother during labor and delivery.
If a woman’s diabetes was not well controlled during pregnancy, her baby can develop low blood sugar after birth. The baby’s blood sugar must be monitored for several hours after delivery.
- Multiple pregnancy. Pregnancy risks are higher for women carrying twins or triplets or higher multiples
- Lifestyle choices:
Smoking, drinking or taking recreational drugs can all increase the risks of complications during pregnancy. Fetal malformation may occur during the 2nd to 8th week of conception.
A safe pregnancy with the delivery of a healthy baby is what every mother wants. The first step in achieving this is to be aware of the conditions that need special care and to work with a Consultant who is experienced in handling this.