Chronic Health Conditions


People who have certain health problems before becoming pregnant are at higher risk for problems during and after pregnancy. These conditions include diabetes, heart disease, hypertension, obesity, anxiety or depression.

New health problems may arise during pregnancy that can affect your pregnancy and health after pregnancy. Tell your provider about any of these conditions so they can help you manage them while you are pregnant and after delivery.


   


Diabetes

Having diabetes or high blood sugar before or very early in pregnancy can increase the risk of birth defects and miscarriage. Developing high blood sugar while pregnant is called gestational diabetes (GDM). Eating a diet lower in sugar and exercising after meals can help lower blood sugars. There are also pills or injections that are safe to use in pregnancy to reduce the chance of complications. Potential problems of diabetes in pregnancy include:

  • Damage to your organs, like the kidneys.
  • Increased risk of developing preeclampsia.
  • Low blood sugar in babies at birth. This may require them to go to the NICU or SCN.
  • Large babies at birth. This can increase the chance of needing a C-section or problems during delivery.
  • Having a baby that is very small. Babies born at a low birth weight or under 5 pounds 8 ounces are at higher risk of having health problems.


Glucose Testing

A glucose test to check for GDM is done between 24 and 28 weeks of pregnancy for those who do not have known diabetes before pregnancy. The test may be done earlier if you have health concerns that put you at high risk. Some risk factors for early testing include being overweight or obese, GDM in a past pregnancy, a first degree relative with diabetes, hypertension or being a member of a high risk race or ethnicity.



High Blood Pressure (Hypertension)

High blood pressure diagnosed prior to pregnancy or before 20 weeks of pregnancy is called chronic hypertension. Your provider will ask if you have been on medications for hypertension before your pregnancy. Your provider may recommend medication if your blood pressure gets too high during pregnancy.

People who have chronic hypertension or develop high blood pressure during pregnancy are at higher risk for developing a condition called preeclampsia. Preeclampsia can lead to life-threatening events during pregnancy, labor or after the baby is born. Such as:

  • Organ failure.
  • Strokes or seizures.
  • Slowed growth of your baby.
  • Preterm delivery.

Your provider will check your blood pressure at every visit.


Risk factors for developing preeclampsia include a past history of preeclampsia and having a chronic medical condition. Taking a low dose aspirin daily starting at the end of the first trimester may lower your risk of developing preeclampsia. Talk to your provider about your risk factors, treatment and any symptoms you may have.

Symptoms of preeclampsia include:

  • Puffiness in hands, feet and face.
  • Vision changes. You may see bright or dark spots.
  • Pain on the upper right side of your belly or shoulder.
  • Headaches that do not go away with medicine.
  • Severe nausea and vomiting in the second half of pregnancy.
  • Sudden weight gain.
  • Difficulty breathing or chest pain.

Call your healthcare provider right away if you have any of these.



   

Asthma

Asthma symptoms can get better, stay the same or get worse during pregnancy. An asthma flare-up during pregnancy can cause low oxygen in blood. This means less oxygen gets to your growing baby. This can put your baby at higher risk for premature birth, low birth weight and poor growth.

  • Your provider will monitor your breathing while you are pregnant and change your asthma medications if needed.
  • Avoid asthma triggers such as pollen, chemical irritants, pet dander and smoke.
  • Take your asthma medication as prescribed. Many asthma medications are safe to use in pregnancy. Speak to your provider about your medication options.

Seizures

It is important to seek prenatal care early and regularly to make sure you and your baby are healthy during pregnancy if you have seizures or epilepsy. If you are on anti-seizure medications your provider will make sure it is safe to use in pregnancy.

They may recommend you take extra folic acid before pregnancy and in the first part of pregnancy to help prevent birth defects. You may also need blood work to make sure you are on the right dose of medications during your pregnancy. Do not stop, start or change the dose of any medication without talking to your provider.


Sickle Cell Disease (SCD)

Sickle cell disease or SCD may get worse during pregnancy and can cause pain episodes more often. Pregnancy can increase your risk for developing a blood clot which may lead to complications such as stroke, heart attack and preeclampsia. It can also put your pregnancy at risk for miscarriage, preterm birth and having a baby with a low birthweight. With early and regular prenatal care most people with SCD can have a healthy pregnancy. It is important to talk to your provider about the medications you are taking for SCD to ensure they are safe to take during pregnancy.