Pregnancy is an exciting time, but it also comes with health risks for both mother and baby. Some pregnancies are considered higher risk than others due to the mother’s age, health conditions, or other factors. Here we will explore which pregnancies tend to be the riskiest and why.
Teenage pregnancy
Teenage pregnancies (ages 15-19) are generally considered high risk. Teens are still growing themselves, so carrying a pregnancy can put extra strain on their bodies. Risks for teen moms include:
- Preterm birth – Teens are more likely to go into early labor and deliver preterm (before 37 weeks). This raises risks for the baby.
- Low birth weight – Teen pregnancies have a higher chance of producing underweight babies.
- Preeclampsia – Teens have a higher risk of developing this dangerous high blood pressure condition.
- Anemia – Teens have higher rates of anemia during pregnancy due to increased iron needs.
Babies born to teen moms also face higher health risks such as neonatal mortality, birth defects, and long-term developmental issues.
Contributing Factors
Why are teen pregnancies high risk? Immaturity of the reproductive system, inadequate prenatal care, poor nutrition, and increased exposure to sexually transmitted infections may all play a role. Many teen moms also continue risky behaviors like smoking and drinking during pregnancy. The combination of biological, behavioral, and social factors adds to the risks for teen moms and their babies.
Pregnancies after age 35
At the other end of the spectrum, advanced maternal age also increases pregnancy risks. After age 35, a woman’s risk of complications steadily rises. By age 40, a pregnancy is considered high risk. Risks associated with later pregnancies include:
- Gestational diabetes
- Preeclampsia
- Placental problems
- Preterm birth
- Stillbirth
- Labor complications
- Cesarean delivery
- Chromosomal abnormalities like Down syndrome
The risks are due to natural aging of the reproductive system. The ovaries produce lower quality eggs. The uterus and placenta function less efficiently. Conditions like hypertension, diabetes, and obesity become more common with age – and all raise pregnancy risks.
Advanced Maternal Age Cut-Offs
What’s considered “advanced maternal age” for pregnancy? General guidelines:
- Age 35+: Higher risk pregnancies
- Age 40+: Much higher risk, require additional monitoring
- Age 45+: Greatly increased risks, not usually recommended
But risks increase gradually over time rather than suddenly at a certain age. A healthy 40 year old may have an easier pregnancy than an unhealthy 35 year old. General health, prenatal care, and individual circumstances matter.
Pregnancies closely spaced
Getting pregnant again too soon after a previous birth also raises risks. The World Health Organization recommends waiting at least 18-24 months between giving birth and getting pregnant again. Women who get pregnant sooner have higher chances of:
- Preterm labor and low birth weight
- Maternal anemia
- Uterine rupture in women attempting VBAC (vaginal birth after cesarean)
- Autism, schizophrenia, and other disorders in baby
Closely spaced pregnancies strain the mother’s body resources. The uterus has less time to fully recover between pregnancies. Depleted nutritional reserves also increase risks for both mother and baby.
How Long to Wait
Ideally, doctors recommend spacing pregnancies 2-5 years apart. The minimum healthy spacing is:
- After cesarean delivery: at least 18 months before conceiving again
- After normal vaginal delivery: at least 12 months
Breastfeeding exclusively can naturally delay the return to fertility for some women. But women should still use contraception if aiming to postpone their next pregnancy.
Pregnancies with multiples
When a woman is carrying more than one baby, it is termed a multiple pregnancy. Twins, triplets, or higher order multiples all raise health risks compared to a singleton pregnancy. Risks associated with multifetal pregnancies include:
- Preterm labor and early delivery
- Low birth weight
- Preeclampsia
- Gestational diabetes
- Fetal growth problems
- Placental problems
- Cesarean delivery
The more fetuses a woman carries, the higher the risks for both mother and babies. The strain of nourishing multiple fetuses taxes the mother’s body. Crowding in the womb often leads to preterm birth and low birth weights.
Contributing Factors
What causes multifetal pregnancies? A few key factors include:
- Heredity – A family history of twins increases the odds
- Fertility treatments – Powerful drugs and IVF often produce multiples
- Maternal age – Odds of twins rises after 35, triplets after 40
Today’s high rates of multiples are mainly due to assisted reproductive technology. Recommended guidelines limit the number of embryos transferred during IVF now to reduce twin and triplet pregnancies.
Pregnancies with health conditions
Many pre-existing maternal health conditions also raise pregnancy risks. Some key examples:
Diabetes
Both gestational diabetes (starts during pregnancy) and pre-existing diabetes in the mother raise risks of:
- Birth defects
- Excessive birth weight
- Preterm birth
- Stillbirth
Tight blood sugar control before and during pregnancy is vital to reducing risks.
Hypertension
High blood pressure, chronic hypertension, and preeclampsia can all lead to serious complications like:
- Placental abruption
- Preterm delivery
- Small for gestational age baby
- Stillbirth
Careful monitoring and control of blood pressure is essential during pregnancy.
Autoimmune Diseases
Conditions like lupus, rheumatoid arthritis, and celiac disease require close medical care during pregnancy. Risks may include:
- Preeclampsia
- Preterm birth
- Low birth weight
- Flares of disease symptoms
Working with both an obstetrician and a specialist for the autoimmune condition is recommended.
Obesity
A high pre-pregnancy BMI raises risks of:
- Gestational diabetes
- Preeclampsia
- Sleep apnea
- Blood clots
- Fetal defects
- Stillbirth
Losing weight before pregnancy, if possible, reduces risks.
Summary of Risk Factors
To summarize, the riskiest pregnancies often involve one or more of these factors:
- Teenage or advanced maternal age
- Closely spaced pregnancies
- Multifetal pregnancies
- Pre-existing maternal health conditions
But risk depends greatly on individual circumstances and proper prenatal care. With close monitoring and management from healthcare providers, many higher risk pregnancies result in healthy moms and babies.
Conclusion
No pregnancy is completely risk-free, but some do face higher odds of complications. Teen moms, older moms, quick repeats, multiples, and pre-existing conditions like diabetes and hypertension all raise red flags. However, good prenatal care from the start of pregnancy is key to reducing risks. Working closely with medical providers and following recommendations can help lead to the best possible outcomes for both mother and child, even in higher risk pregnancies.