High-Risk Pregnancy Health Article

Definition

A pregnancy that has maternal or fetal complications requiring special medical attention or bed rest is considered to be high-risk. Complications, as used here, mean the risk of illness or death before or after delivery is greater than normal for the mother or baby.

Description

Risk factors in pregnancy are those findings discovered during prenatal assessment that are known to have a potentially negative effect on the outcome of the pregnancy, either for the woman or the fetus. This evaluation determines whether or not the mother has characteristics or conditions that make her or her baby more likely to become sick or die during the pregnancy.

Causes and symptoms

All risk factors do not threaten pregnancy to the same extent. The risk of complications is increased by smoking, poor nutritional habits, drug and alcohol abuse, domestic violence, prepregnancy maternal health status, psychosocial factors, prior health care, the presence of chronic medical problems in the mother, past history of repeated preterm delivery, multiple gestation, and abnormalities of the fetus or placenta. A woman with a high-risk pregnancy may have an earlier labor and delivery depending upon the fetal or maternal complication present and, likewise, present with symptoms dependent upon the condition. Since the placenta supplies the baby with its nutrients and oxygen, any condition that threatens the blood supply to it threatens fetal development.

The threat of a preterm delivery is the most common reason for a referral to a perinatal center, which is linked to obstetric and newborn services that provide the highest level of care for a pregnant woman and her baby. A preterm delivery may occur because of a premature rupture of membranes (the bag of water surrounding the baby breaks) or preterm labor. There is a strong correlation of vaginal or uterine infection with the pregnant woman's water breaking, and there are lab tests that can be predictive of a woman's risk of experiencing preterm labor.

According to a 2001 report from the U.S. Centers for Disease Control and Prevention, there were 29.6 deaths per 100,000 births among African-American women between 1991 and 1997. The rate for women of Hispanic origin was 10.3, and for white women it was 7.3. The rate for Asian women was unavailable. The second most common causes of death in women are problems related to pregnancy and delivery, including blood clots that travel to the lungs, anesthesia complications, bleeding, infection, and high blood pressure complications. A baby dies before, during, or after birth in 16 out of 1,000 deliveries in the United States. Almost 50% of these deaths are stillbirths, which are sometimes unexplained. The rest of the deaths occur in babies up to 28 days old, and the leading cause of these is birth defects, followed by prematurity. Risk factors can be present before pregnancy occurs and others develop during pregnancy.