What Is a High-Risk Pregnancy?

A high-risk pregnancy is one in which you, your baby, or both are at higher risk of health problems during pregnancy or delivery than in a typical pregnancy. It often requires care from specially trained providers.

Some pregnancies become high risk as they progress, while others are at increased risk for complications before the pregnancy begins due to chronic conditions like diabetes and high blood pressure or complications from a previous pregnancy, or other issues. Up to a third of pregnancies around the globe fall into this category.

You can't always avoid a high-risk pregnancy, but early and regular prenatal care can help you have a healthy pregnancy and deliver your baby without complications.

Risk Factors

Certain chronic conditions, age, lifestyle factors, and pregnancy complications can increase your chances of having a high-risk pregnancy.

Chronic Conditions

Chronic health conditions that you have before your pregnancy or ones that you develop during your pregnancy can increase the risk of complications for both you and your baby. These conditions include:

• High blood pressure, which is linked to kidney damage and preeclampsia
• Polycystic ovary syndrome (PCOS), which is associated with an increased risk of pregnancy loss before 20 weeks
• Diabetes, which is associated with metabolism problems for the pregnant person and birth defects for the baby
• Kidney disease, which is linked to preterm delivery, preeclampsia, and low birth weight
• Autoimmune diseases, such as rheumatoid arthritis and multiple sclerosis, which are associated with preterm birth or birth defects from medications
• Thyroid disease, which is linked to a low birth weight and developmental problems in the baby
• Obesity, which is associated with structural heart problems in the baby or delivery problems
• HIV/AIDS, where the virus can be transmitted from the pregnant person to the baby

Age

Being younger or older than a certain age can affect the health of you and your baby during and after pregnancy. People who become pregnant in their teen years are at higher risk of developing problems like high blood pressure, anemia, preterm delivery, and lack of prenatal care.

On the other end of the spectrum, people who are older than 35 when they first become pregnant may experience complications like:

• High blood pressure or preeclampsia
• Ectopic pregnancy
• Gestational diabetes
• Delivery complications or prolonged labor

Lifestyle Factors

Lack of exercise and an unhealthy diet can lead to chronic conditions like obesity, resulting in complications for you and your baby during and after pregnancy.

Other lifestyle factors that can lead to a high-risk pregnancy are alcohol and drug use and cigarette smoking. Drinking alcohol, using drugs, and smoking can contribute to problems like stillbirth, low birth weight, and physical or developmental problems for the baby.

Research has shown that chronic stress from racism can affect the health of Black women both before and during their pregnancy and increase their risk of chronic diseases at an earlier age than White women.

Pregnancy Issues

Your baby may have the following issues if you have a high-risk pregnancy:

Your baby may have the following issues if you have a high-risk pregnancy:

• Preterm birth: This puts a baby at risk for a number of immediate and long-term health complications.
• Birth or genetic defects: These may require procedures before delivery (in utero) or immediate care at birth.

Complications

A person with a high-risk pregnancy has about a 25% higher chance of complications than someone whose pregnancy is not high risk.

Some of the most significant complications in high-risk pregnancy involve pregnancy loss, preterm delivery, gestational diabetes, and high blood pressure. There are many causes and contributing factors for each of these complications.

High blood pressure and gestational diabetes can be related to lifestyle factors, the person's pre-pregnancy health, and even the mother's or father's genetic history. Your doctor will address risk factors individual to your personal and family health history at the beginning of your pregnancy to try to prevent any complications.

Finally, preterm delivery is a complication of many chronic diseases, pregnancy issues, age, and lifestyle choices. Drug and alcohol use can lead to preterm delivery, but it may also occur for more natural reasons, like problems with how the placenta developed.

You will be monitored throughout your pregnancy for signs of physical or development trends that could lead to preterm birth. If preterm birth is likely, your doctor may recommend lifestyle changes, bed rest, or even hospitalization to help delay delivery as long as possible.

Coping

There are many ways your high-risk pregnancy can be managed. You will most likely need more visits with your obstetrician, more frequent testing, and closer surveillance. If your pregnancy is high risk because of an issue with your baby, a maternal-fetal specialist, or perinatologist, may be consulted.

It can be difficult to cope emotionally. If you need help managing your health or coping with the strain of a high-risk pregnancy, ask your healthcare provider for help. Community or hospital counselors or support groups may be critical to offering you, your partner, and your baby the help you need.

Summary

A high-risk pregnancy is one in which you and your baby are at higher risk of developing complications during and after pregnancy. Some chronic conditions like diabetes and high blood pressure and lifestyle factors like maternal smoking can increase your risk of having a high-risk pregnancy. Some complications common in high-risk pregnancy include gestational diabetes, preeclampsia, preterm birth, and low birth weight for the baby.

A Word From Verywell

Different factors could lead to a high-risk pregnancy. These include chronic conditions in the pregnant person, congenital problems with the baby, or other factors like how the placenta develops. If you have a condition that would make your pregnancy high risk, like diabetes or drug use, you should talk to your doctor about your risks before becoming pregnant.

If you are already pregnant and have a high-risk pregnancy, obstetric and perinatal specialists will help you and your baby make it through the pregnancy successfully. This may include additional ultrasounds, a specific birth plan, bed rest, or additional care after delivery.

Coping with a high-risk pregnancy can be difficult physically and emotionally. It may be helpful to find a support system or ask your doctor for support if you or your partner are struggling to get the care you need to cope with your condition.

Frequently Asked Questions

At what age is pregnancy high risk?

Being on either the younger or older end of the maternal age spectrum can increase risk. Those who are under age 19 or over age 35 are considered to be at high risk, and they are more likely to experience pregnancy complications.

What is a high-risk pregnancy doctor called?

A maternal-fetal specialist, or perinatologist, will oversee your baby's care if you have a high-risk pregnancy. You will also continue working with your obstetrician. The two medical professionals will work together to help you bring your pregnancy to term.

How many ultrasounds do you need for a high-risk pregnancy?

There is not a specific number of ultrasounds you will need or have in a high-risk pregnancy. It will depend on the specific condition that makes you high risk and what your doctor thinks is appropriate.