Maternal Risk Factors

High Blood Pressure

What is high blood pressure (Hypertension)?

High blood pressure (also called hypertension) is a serious health condition that can increase risk during pregnancy. High blood pressure is when the force of your blood pushing against the walls of your blood vessels is consistently too high. High blood pressure can increase the likelihood you or your baby will have health issues. This includes having preeclampsia or eclampsia. Preeclampsia causes high blood pressure during pregnancy. Eclampsia is a life-threatening complication of preeclampsia. Eclampsia occurs when people with preeclampsia develop seizures or experience coma. Preeclampsia and eclampsia usually begin at or after 20 weeks of pregnancy and can cause damage to your kidneys, lungs, heart, eyes, or brain.

Postpartum preeclampsia can occur between 48 hours and six weeks after you give birth. Symptoms usually include:

• High blood pressure
• Severe headache
• Visual changes
• Upper abdominal pain
• Nausea or vomiting
• Swelling in the legs, hands or face
• Trouble breathing
• Sudden weight gain

How can high blood pressure affect your pregnancy?

High blood pressure during pregnancy can increase your short- and long-term risk for high blood pressure, heart disease, and stroke later in life. High blood pressure during pregnancy is the most common risk factor for pregnancy-related stroke. Stroke can happen during pregnancy and the days and weeks after giving birth. More than one half of postpartum strokes will happen within 10 days after discharge following delivery.

If you have severe high blood pressure during your delivery-hospitalization, your doctor will schedule a follow up visit within three days after you are discharged from the hospital. It is important to attend this appointment and talk with your doctor about your long-term health risks.

• Learn about the signs and symptoms of preeclampsia.
• Read about things you can do to help manage your blood pressure before, during and after pregnancy.

Mental Health: Depression and Anxiety

What are depression and anxiety?

You go through many physical and emotional changes during and after pregnancy. Emotional changes could include depression and anxiety, which are common mood disorders. Depression can make you feel sad and lose interest in activities you normally enjoy. Anxiety can make you feel excessively nervous, worried and scared. These conditions can happen during pregnancy. They can also happen anytime during the first year after your baby is born. If you experience depression during your pregnancy, you are at a greater risk of developing postpartum depression.

Postpartum depression, such as intense feelings of sadness, anxiety, or despair, happens after your baby is born.

It may cause you to:

• Lose your appetite,
• Become easily or intensely irritated, or
• Have a hard time bonding with your baby.

How can depression and anxiety affect you while you are pregnant or after you give birth?

If you have depression or anxiety, you may have a difficult time bonding with your baby. This can affect how your baby develops. Depression during pregnancy can also cause you to give birth too early. It can interrupt your daily activities and make it hard to care for yourself and your baby. Early treatment is essential for good mental health. Talk to your health care provider if you feel any symptoms of depression or anxiety. There are many mental health resources available to you, and it’s okay to ask for help. 

Diabetes

What is diabetes?

Diabetes is a condition that affects how your body turns food into energy. Some common symptoms include excessive hunger, thirst, or fatigue. There are several types of diabetes: type 1, type 2, and gestational diabetes. If you have type 1 diabetes, your body doesn’t produce enough insulin. Our bodies need insulin to help blood sugar enter our cells so it can be used for energy. Type 2 diabetes is when your body produces insulin, but doesn’t use it well. Gestational diabetes develops when you have high blood sugar during pregnancy. If you develop this condition, you are more likely to develop type 2 diabetes later in life. Gestational diabetes increases risk for having high blood pressure or preeclampsia during pregnancy, as well as heart disease and stroke later in life.

How can diabetes affect pregnancy?

If you have diabetes or develop diabetes during your pregnancy, you are more likely to have a cesarean delivery (C-section). You are also more likely to develop type 2 diabetes in the future. Gestational diabetes can cause your baby to be too big when born. It can also increase the likelihood of your baby becoming overweight. Managing diabetes during pregnancy can help you have a healthy pregnancy and a healthy baby. Talk to your doctor if you experience any of the symptoms of diabetes. Read about things you can do to help manage your diabetes before, during and after pregnancy. 

Maternal Age

Your age during pregnancy matters. If you are older or very young, it’s important for you to know about the increased risk for poor health outcomes for you and your baby. If you are pregnant after age 35, you are more likely to have conditions like gestational diabetes and pregnancy-related high blood pressure or preeclampsia. You are at greater risk for heavy bleeding or hemorrhage during and after delivery. You are also at greater risk for complications during labor like prolonged labor (labor lasting more than 20 hours), labor that does not progress, or a C-section delivery.

If you are young, especially if you are a teenager, you are more likely to have preeclampsia and anemia (not enough healthy red blood cells). You are also more likely to have preterm (early) labor.

To learn about how your age can affect your pregnancy, talk to your doctor.

Pre-pregnancy Weight (Obesity)

Gaining some weight is a normal part of a healthy pregnancy, regardless of your body shape or size. Your recommended weight gain is based on your weight before pregnancy. Most plus-sized (Body Mass Index >30) pregnant women have healthy pregnancies. But, if you are plus-size, it’s important to know that you are at higher risk for having preeclampsia, gestational diabetes and a C-section delivery. You are also more likely to have your baby too early, or have a miscarriage or stillbirth.

If you are plus-size, speak with your doctor about your diet, physical activity, health history, and any health conditions you may have. Together, you and your doctor can develop a healthy pregnancy plan that is right for your health needs.

Visit the national Pregnancy for Everybody campaign for more information about planning for a healthy pregnancy. 

Infections

Infections can have serious consequences for your health, your pregnancy, and your baby’s health. This includes COVID-19, tuberculosis, HIV, viral hepatitis, sexually transmitted diseases (STDs), Zika virus, flu, and other kinds of infections. You won’t always know if you have an infection, and sometimes you might not even feel sick.

To identify and treat infections, have regular visits with your doctor during pregnancy and postpartum. Speak with your provider if you feel sick or think you might have been exposed to an infection.

• Review tips for preventing infections before and during pregnancy.
• Review things you need to know about vaccines and pregnancy.
• Learn about infections that can affect pregnancy.
• Learn about STDs during pregnancy.
• Learn about congenital syphilis.
• Learn about symptoms and treatment for common infections during pregnancy.

Substance Use and Substance Use Disorders

Using substances during pregnancy can cause serious health problems for you and your baby. Substances like:

• Alcohol
• Prescription medications
• Street drugs
• Or a combination of substances

Using these substances can increase your risk of:

• Severe hypertension
• Problems with your placenta (the organ that connects your unborn baby to your uterus and gives your baby nutrients and oxygen)
• Heavy blood loss or hemorrhage during pregnancy, labor or after delivery
• Overdose or death

Substance use may cause your baby to be born too early or have low birthweight. It may also cause your baby to have withdrawal symptoms after birth because of exposure to drugs while you are pregnant. Substance use during pregnancy can affect your baby’s development. It also  increases the chances for birth defects, stillbirth, and sudden infant death syndrome.

There is no known “safe” level of alcohol intake for pregnant women. All types of alcohol are equally harmful when you drink while pregnant.

Tobacco, e-cigarettes, and other products containing nicotine are not safe to use during your pregnancy. Quitting smoking is one of the most important ways you can protect your health and the health of your baby.

If you are pregnant or planning to get pregnant – and using any substances including opioids, stimulants, alcohol, tobacco, marijuana, or other drugs – talk to your doctor. Get more information to make the safest choices for you and your pregnancy.

If you need treatment for substance use, regardless of ability to pay, visit an Outreach, Screening, Assessment and Referral Counselor at your Local Mental Health Authority or visit hhs.texas.gov/osar.

Read how substance use can affect you and your baby during pregnancy.

Intimate Partner Violence

Abuse comes in many forms. It can include:

• Physical abuse
• Emotional and verbal abuse
• Sexual abuse
• Reproductive coercion (when a partner uses pressure, guilt, shame or force to control whether or not you get pregnant or have a baby)
• Human trafficking
• Financial abuse
• Digital abuse (when a partner uses technology or the internet to stalk, harass, intimidate, bully or control you)

Abuse of any kind is never okay, and abuse during your pregnancy can make your journey very hard and lonely.
 

An abusive partner can cause emotional pain and/or physical pain. This can result in a miscarriage or vaginal bleeding. When you visit your health care provider for prenatal care, it might be a good time to talk about what is going on in your relationship.

How much you choose to say is your choice. It is the provider’s job to focus on the health and safety of you and your baby. Read about how to stay safe during your pregnancy and beyond. Learn more about the Family Violence Program.