It's a scary-but-true fact that dangerous complications can strike a woman and her baby at any time during pregnancy. One of the most serious -- and, sadly, a leading cause of maternal and infant mortality -- is preeclampsia, a condition that affects 5 to 8 percent of all pregnancies. How can you know if you're at risk for this pregnancy condition?
Who's at risk
Preeclampsia is one of those perplexing pregnancy disorders that seem to have no rhyme or reason; it can occur in any woman, and while most cases develop in the third trimester (particularly after 37 weeks of pregnancy), it can develop as early as 20 weeks. But according to the Preeclampsia Foundation, there are numerous risk factors that can make a woman more likely to develop preeclampsia, including:
- Previous history of preeclampsia
- Family history of preeclampsia in a mother, sister, or aunt
- First pregnancy or first pregnancy with a new partner
- Prolonged intervals between pregnancies
- Chronic hypertension or high blood pressure
- Underlying kidney problems
- History of an organ transplant
- A pregnancy with multiples
- Extreme maternal age (under 18 or over 40)
- Lupus or another autoimmune disease
- In-vitro fertilization
- Sickle-cell disease
- Polycystic ovarian syndrome
Much still remains unknown about preeclampsia, but researchers theorize that the disease may have an autoimmune basis, meaning that a woman's immune system is triggered to attack her own body. (That's also why women with autoimmune disorders have an increased risk of developing preeclampsia.)
That suspected immune system link also means that first-time moms or moms having a baby with a new partner are actually more at risk than second-time mothers or mothers having another baby with a same partner. "If you have had preeclampsia in the past and you keep your same partner, your risk lowers," says Pedro P. Arrabal, M.D., medical director of the Institute for Maternal-Fetal Medicine at Sinai Hospital in Baltimore. "Part of the theory is that the mother is being exposed to different antigens, which might be a trigger. So if the mom has seen those antigens in the past, the chances [of developing preeclampsia] are less."
A strong family history is also a precursor for preeclampsia. "There is a genetic basis, so if your mother or sister had it, you have a higher risk," Dr. Arrabal says.
Other theories include the mother's body having an inflammatory reaction, the pregnancy itself, and nutritional deficiencies -- in calcium or Vitamin D, for instance -- trigging the disorder.
Race also seems to play a part: One study found that black and Hispanic women had a much higher rate of preeclampsia, along with higher rates of other pregnancy complications, such as diabetes, that placed them at an increased risk of preeclampsia.
Will it happen again?
Unfortunately, developing preeclampsia in one pregnancy puts you at an increased risk of developing it again -- and that's especially true for women who develop a severe form of preeclampsia prior to 30 weeks. But "it isn't possible to predict preeclampsia," says Lisa Valle, D.O., an ob-gyn hospitalist at Saint John's Health Center in Santa Monica, California, who notes that the recurrence rate for it falls between 5 and 70 percent.
Other factors that might increase the chance of recurrence include high blood pressure or diabetes after the first pregnancy, in-vitro fertilization, or being pregnant with multiples. Women who had preeclampsia with a first pregnancy, but not a second, are still at risk for developing the condition again in future pregnancies. There is one bit of good news, though: Moms who get preeclampsia again tend to get it later in their pregnancies and have milder cases, Dr. Arrabal says.
If you're concerned about developing preeclampsia, be sure to alert your healthcare provider: Discuss your risk factors, if any, and watch for symptoms such as severe swelling, constant headaches, stomach pain, or vision changes that may indicate a problem.
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