By Alisha Sangal, MD
Pregnancy is a remarkable journey, but it can also present challenges that require attention and care.
While most pregnancies progress smoothly, certain complications can arise, potentially affecting the health of the mother and baby.
If you are considering becoming pregnant or are already expecting, it is important to talk with your doctor about common complications and how to reduce your risk.
Penn Medicine Princeton Health offers complete maternity care to maintain a healthy pregnancy, including care for hypertension, diabetes and other conditions.
Hypertension
Hypertension, or high blood pressure, can exist prior to pregnancy or develop during pregnancy. When it develops after 20 weeks of pregnancy, it is considered gestational hypertension and thought to be caused by abnormal blood vessels in the placenta and uterus.
Hypertension during pregnancy can be dangerous as it can lead to preeclampsia, which can affect the mother’s liver and kidney function and in rare cases may progress to eclampsia, a serious condition characterized by seizures.
Pre-eclampsia can also lead to HELLP syndrome, a severe liver and blood disorder.
According to the National Institutes of Health (NIH), preeclampsia occurs in 3-7% of all pregnancies and can increase the risk of preterm delivery and low birth weight.
Moreover, preeclampsia increases your risk for developing high blood pressure later in life. You also have a higher chance of heart disease, heart attacks and strokes.
Diabetes
Whether you have type 1 or type 2 diabetes before pregnancy or develop diabetes during pregnancy (gestational diabetes), you are at risk for pregnancy and childbirth complications.
Gestational diabetes occurs when pregnancy hormones inhibit insulin from doing its job and most often starts halfway through the pregnancy. Upward of 10% of pregnant women develop gestational diabetes, according to the NIH.
In most cases of gestational diabetes, blood sugar levels return to normal after delivery.
For women with type 1 or type 2 diabetes, high blood glucose levels at conception and during early pregnancy increase the risk for complications such as birth defects, stillbirth and preterm birth.
Additionally, any type of diabetes during pregnancy can cause the baby to grow too large and become stuck in the birth canal during delivery, necessitating a cesarean section. What’s more, it increases the risk of the baby developing obesity or type 2 diabetes in the future.
Iron Deficiency Anemia
Anemia is having a lower number of healthy red blood cells. Red blood cells deliver oxygen throughout your body. Iron is required to make red blood cells, and when you’re pregnant, your body needs a lot more blood to support the healthy growth of the baby.
As a result, your iron levels can become depleted, leading to a lower-than-normal amount of red blood cells, or iron deficiency anemia.
When this happens, it can lead to fatigue and low energy. In severe cases, iron deficiency anemia can cause the baby to not grow as well and could compromise the blood flow to the placenta during childbirth. This can result in the baby not getting enough oxygen and being unable to tolerate the stress of childbirth.
Individuals who have a vegetarian or vegan diet are at greater risk for iron deficiency anemia during pregnancy than those who eat meat. Having a balanced diet high in iron and fiber is a great way to maintain a healthy level of red blood cells during pregnancy.
Anxiety and Depression
Maternal mental health is just as important as physical health during pregnancy.
Undiagnosed or inadequately treated mental health conditions, such as anxiety and depression, can worsen during pregnancy because of hormonal and physical changes as well as social stressors, including job pressures and other family responsibilities.
In addition, women without a history of mental health conditions are at risk for developing postpartum depression.
Many new mothers experience the baby blues in the first two weeks after childbirth. This is a common occurrence and doesn’t indicate depression. However, if the symptoms last beyond two weeks, they could be cause for concern.
Symptoms of postpartum depression may include feelings of hopelessness and guilt, lack of joy in parenting or interacting with their child, excessive worry, sleeping too much or not sleeping enough, and feeling sad all the time for no reason.
Tips for a Healthy Pregnancy
One of the best things you can do to reduce your risk for complications during pregnancy is to see your doctor regularly and be sure to get all of your lab work completed on time.
In general, your doctor will see you once a month for the first 28 weeks of pregnancy, every two weeks between 28 and 36 weeks of pregnancy, and every week for 36 through 40 weeks of pregnancy.
Other steps you can take for a healthy pregnancy include:
• Being up to date on all your screening tests such as blood pressure and blood sugar, prior to getting pregnant.
• Ensuring any pre-existing health conditions are well-managed.
• Taking a prenatal vitamin with folic acid, iron and calcium.
• Eating a balanced diet rich in fruits, vegetables, whole grains, and lean proteins.
• Staying active by engaging in moderate physical activity such as walking, swimming, or prenatal yoga as long as your doctor gives the OK.
• Avoiding harmful substances such as cigarette smoke, alcohol and illicit drugs.
• Getting enough sleep. It is recommended that adults, including pregnant women, get between seven and nine hours of sleep nightly.
Also, if you are thinking about becoming pregnant, make an appointment with your OB/Gyn for preconception planning. This will give you an opportunity to talk about any risk factors or concerns you may have before you conceive.
Every woman’s pregnancy is unique, and though complications can occur, with the appropriate care, they can be diagnosed and managed effectively so that mother and baby stay healthy throughout the nine-month journey and beyond.
To find an OB/Gyn affiliated with Penn Medicine Princeton Health, call (888) 742-7496 or visit www.princetonhcs.org.
Alisha Sangal, MD, specializes in obstetrics and gynecology and is a member of the medical staff at Penn Medicine Princeton Health.
