Raising Awareness of Preeclampsia: How to Protect Your Pregnancy

If you’re pregnant or looking to become pregnant, you may have heard about a condition called preeclampsia. A complication that appears late in pregnancy, preeclampsia occurs in about 1 in 25 pregnancies in the U.S., according to the Centers for Disease Control and Prevention. 

May is Preeclampsia Awareness Month, which offers a great opportunity to share what we know about this serious condition and how you can protect yourself or a loved one. 

Defining Preeclampsia 

Preeclampsia is a type of high blood pressure that occurs after 20 weeks of pregnancy. Without treatment, it can affect the entire body, causing kidney and liver failure, and can be fatal. 

Unfortunately, little is known about why it occurs. Some evidence suggests that it is related to problems with umbilical cord development, inflammation and nutritional deficiencies, but researchers haven’t successfully identified a single underlying cause.  

Who’s at Risk? 

The American College of Obstetricians and Gynecologists divides risk factors into those that put a woman at high risk and those that put a woman at moderate risk. 

Factors considered high risk include: 

  • A diagnosis of preeclampsia in a previous pregnancy 
  • A pregnancy involving multiples (twins, for example) 
  • Having an autoimmune disease, such as lupus 
  • Having chronic high blood pressure (hypertension) before or during pregnancy 
  • Having multiple moderate risk factors 
  • Pre-existing health conditions, including diabetes and kidney disease 

Moderate risk factors include: 

  • Being age 35 or older 
  • Being Black 
  • Complications during a previous pregnancy 
  • Family history of the disease 
  • First pregnancy or a pregnancy that’s 10 years after a previous pregnancy 
  • Having had in vitro fertilization 
  • Obesity 
  • Socioeconomic factors, such as low income 

Many of these risk factors are more common today than they were 20 to 30 years ago. For example, more women, especially in New York, are having their first child after age 30, and obesity is more prevalent. 

“This is why it's so important to be aware of preeclampsia, because it's one of the major causes of severe maternal complications for people giving birth, not only in the United States, but across the world,” says Georges Sylvestre, M.D., assistant attending OB-GYN at NewYork-Presbyterian Hospital and assistant professor of clinical obstetrics and gynecology at Weill Cornell Medical College Cornell University. “It's one of the main three causes of mortality in childbirth and pregnancy.” 

The Importance of Prenatal Care 

Although preeclampsia sounds concerning, it can be managed and controlled with regular prenatal care.  

During prenatal visits, OB-GYNs monitor a woman’s blood pressure and perform tests that look for proteins in urine, which often occur alongside high blood pressure. 

“We don’t have any very specific markers that can predict that preeclampsia is going to happen,” Dr. Sylvestre says. “That's why it remains a challenge.” 

However, he adds that doctors have found success with regular monitoring of blood pressure, whether in an office or at home.  

“In terms of surveillance for preeclampsia, and we've noticed that, for women particularly at risk of preeclampsia, taking blood pressure frequently allows us to catch it in time,” he says. “The earlier you recognize it, the less likely you are to have complications. Surveillance is very important.” 

In addition, patients with risk factors can talk to their doctors about taking a daily low-dose aspirin for prevention. 

“We’ve tried many medications to prevent preeclampsia, and the results have been very disappointing,” Dr. Sylvestre says. “We’ve tried calcium, low-salt diet, antihypertensives [medications to lower blood pressure], and vitamins, but nothing has really worked to prevent it except baby aspirin. A tiny dose of aspirin can cut down the rate of preeclampsia by about 50%, and that can have a huge impact in the world of women at risk for preeclampsia.” 

Treatments for Preeclampsia 

Treating preeclampsia depends on how far along a pregnancy is.  

“If a woman is at full term, 37 or 39 weeks, we generally recommend delivering the baby,” Dr. Sylvestre says. “Delivery always treats preeclampsia.” 

Treatments are less straightforward if preeclampsia occurs before a baby reaches full term. Preterm babies don’t have fully developed systems, which can increase their risk of health problems, so managing a mother’s high blood pressure until the baby is healthy enough for delivery could be the best option for both.  

“When we have preterm preeclampsia, as we call it, we determine how stable or unstable the mother is,” Dr. Sylvestre says. “If she is deemed stable with mild preeclampsia, very often we can keep the pregnancy going and monitor it very closely. Sometimes the woman has to be hospitalized, and sometimes we can watch it as an outpatient. But importantly, she'll be very, very closely monitored.” 

Preventing Preeclampsia in Future Pregnancies 

Having preeclampsia in one pregnancy increases the risk of it occurring in future pregnancies. If a woman wants to expand her family, Dr. Sylvestre emphasizes the need for prenatal care. 

“If you have pre-existing conditions such as chronic hypertension or diabetes, for instance, it's important that you check up with your doctor before you even try to attempt pregnancy,” he says. “We can manage the diabetes or hypertension in a way that makes a woman less at risk of having preeclampsia in a future pregnancy.” 

Knowing a woman has a history of preeclampsia also gives doctors more options for early intervention. 

“Because she's been identified as high risk, she'll most likely be placed on baby aspirin and probably have more frequent checkups with the doctor to monitor the blood pressure,” he says. “That way if preeclampsia happens again, we can intervene quickly. 

“High-risk prenatal care services are so important,” Dr. Sylvestre says. “Be sure that you seek the care of a physician who is very comfortable and familiar with preeclampsia and with women at risk for preeclampsia. That way, we can intervene early, for you to enjoy a safe pregnancy and a healthy baby.” 

Having a baby or trying to become pregnant? Find a doctor at Weill Cornell Medicine who can help.