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Roughly 5-8% of pregnancies in the United States include a preeclampsia diagnosis. While most deliver healthy babies, it can be fatal for both mother and baby, if left undiagnosed. According to the Agency for Healthcare Research and Quality, the rate of preeclampsia is 60% higher for Black women, and in a country where the maternal mortality rate leaves much to be desired, this can be a compelling statistic for those pregnant or thinking of becoming pregnant to take note of.
Preeclampsia is high blood pressure specific to pregnancy and is associated with rapid progression of symptoms such as low platelet count, impairment of kidney function, high creatinine levels and high protein count in urine. For pregnant women, this can typically look like a sudden onset of:
- Headaches
- Spots in vision
- Unexplained swelling
- Nausea
- Vomiting
- Upper abdominal pain
- Bleeding
“More women who are in their first pregnancies are associated with preeclampsia than second or third or fourth pregnancies,” Aneesha Varrey, MD, maternal fetal medicine specialist and high risk obstetrician at Perinatal Associates at GBMC Health Partners, said. “However, for those diagnosed prior to 32 weeks, the risk of recurrence is up to 30%. If you are diagnosed with preeclampsia after 34 weeks, the risk of recurrence is much lower in the second pregnancy with the same father.”
Changes in partner could be a risk of preeclampsia as well as extremes in age, meaning teen pregnancies or for women over the age of 40. Higher BMI, diabetes, smoking, or anything that effects blood vessel health could also result in a higher risk of preeclampsia.
There is a spectrum of how severe preeclampsia develops so consistent monitoring is important. Following a diagnosis, obstetricians will have pregnant women schedule visits every week or twice a week depending on what stage the diagnosis is. Blood pressure is checked at each appointment as well as ongoing education about symptoms and when it could become severe preeclampsia.
Depending on the severity, women diagnosed with preeclampsia can deliver anywhere between 34-37 weeks, according to Dr. Varrey.
“We don’t recommend staying pregnant after 37 weeks with a diagnosis of preeclampsia,” she said. “The risk of eclampsia, risk of end organ damage—which is kidney function or cerebral function—all of that decompensates after 37 weeks. So, we don’t recommend going past 37 weeks for the baby or for the mom.”
There is not any scientific research to explain the discrepancy in rate of preeclampsia for Black mothers. While Black women do tend to have higher rates of the chronic diseases associated with preeclampsia risk factors, socioeconomic disparities and implicit bias play a huge role in Black women not getting the care or attention they need.
Monitor symptoms, advocate for care and testing if something does not feel right, and get a second opinion if needed. No woman should suffer in silence.
