Preeclampsia During Pregnancy: What Is Your Risk?

Medically Reviewed By Stacy A. Henigsman, DO
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​​Preeclampsia is a dangerous pregnancy complication that doctors associate with high blood pressure and elevated protein levels in urine. Current research suggests that race and certain health conditions may be risk factors. Preeclampsia occurs in about 1 in 25 pregnancies in the United States. Doctors define preeclampsia as high blood pressure that develops during pregnancy at week 20 or later.

Preeclampsia is a serious condition that poses a risk to both the pregnant person and the fetus or fetuses. People with a history of chronic high blood pressure and diabetes may have a higher risk of developing preeclampsia. 

This article will discuss how to identify your potential risk of developing preeclampsia and how to spot it in its early stages. It will also look at recent data on preeclampsia risk relating to race and ethnicity.

Sex and gender terms

Sex and gender exist on spectrums. To accurately reflect source materials, this article sometimes uses the terms “mother” and “women” to describe people assigned female at birth.

What are the risk factors for preeclampsia?

Preeclampsia occurs most often in first pregnancies. However, people who had preeclampsia in a prior pregnancy are seven times more likely to experience it in a future pregnancy. 

The following are also risk factors: 

  • a family history of preeclampsia 
  • chronic high blood pressure before pregnancy
  • obesity and overweight
  • pregnancy past age 40 years
  • being pregnant with more than one fetus 

People with preexisting conditions may experience a higher risk for preeclampsia. These include:

Some studies suggest that certain populations may experience preeclampsia more than others.

What is the risk of preeclampsia by race and ethnicity?

Close-up of Black pregnant person holding bare belly
1340020013 DisobeyArt/Getty Images

In 2020, researchers from the University of North Carolina and the University of South Florida conducted a literature review of studies on how race and ethnicity may play a role in preeclampsia.

Most of the studies examined revealed that non-Hispanic Black people and American Indian or Alaskan Native people were disproportionately affected by preeclampsia. We highlight specific studies below. 

Black and African American people

The Agency for Healthcare Research and Quality published a study in 2017 on preeclampsia cases. They found that preeclampsia was 60% more common in Black study participants than in white study participants. 

In a separate study from the American Heart Association (AHA), researchers found that the risk of preeclampsia was higher in Black women born in the U.S. compared with Black women who were immigrants to the U.S.

Hispanic and Latinx people

In 2021, researchers studying nativity-related disparities in preeclampsia cases conducted a peer review of past studies on the topic. Some of the studies they reviewed showed a positive correlation between Hispanic ethnicity and an increased risk of preeclampsia compared to white women.

However, other studies showed that Hispanic people have a similar or even lesser risk of developing preeclampsia than Black women. 

White people

The peer review also found that white people born in the U.S. had lower preeclampsia rates than white immigrants. However, the study did not conclude the reason for this trend. 

Asian and Pacific Islander people

For nearly 2 decades, researchers studied inpatient data for delivery hospitalizations in Hawaii. They discovered that Native Hawaiian, other Pacific Islanders, and Filipino study participants had a higher risk of preeclampsia compared with white study participants.

The researchers believe that their findings suggest that these high-risk groups may require more frequent monitoring for preeclampsia. 

It is important to note that race and ethnicity alone do not indicate preeclampsia risk, and that social, economic, and environmental factors also play a role.

How can you reduce your risk of preeclampsia?

When family planning, talk with your doctor about ways to reduce your risk of preeclampsia. For example, managing diabetes and hypertension may lower the risk. 

The U.S. Preventive Services Task Force recommends that pregnant people with risk factors for developing preeclampsia take low-dose aspirin as preventive medication after 12 weeks of gestation. However, you should always consult with your doctor before starting a new medication. 

What are the symptoms of preeclampsia?

Many pregnant people with mild preeclampsia do not feel ill. For this reason, it is important to receive routine checkups and blood work during pregnancy. People with preeclampsia have high blood pressure and protein in their urine.

Other symptoms of preeclampsia include:

Preeclampsia requires immediate medical care, including medication to lower blood pressure. If you experience any of these symptoms while pregnant, contact your OB-GYN immediately.

What causes preeclampsia?

Medical researchers are still studying why some pregnant bodies are not able to adjust to increased blood volume to support a fetus.

However, some doctors believe preeclampsia relates to an issue with the placenta. The placenta is the link between the mother’s blood supply and the fetus.

A 2019 research-supported theory shows a link between the pregnant person’s blood supply and the fetus. Doctors theorize that when the placenta does not connect properly to arteries in the uterus, the placenta may not receive enough blood. 

This can lead to constriction of blood vessels, which can cause blood pressure to increase and the kidneys to release protein into urine.

What are the possible complications of preeclampsia?

Most pregnant people with preeclampsia do not experience complications and give birth to healthy infants. However, treatment for preeclampsia is still necessary to reduce the risk for both the pregnant person and the fetus. 

For the child

One common preeclampsia complication is premature birth. Preeclampsia is responsible for 15% of premature births.

Giving birth before 37 weeks may cause complications that impact the infant’s health, such as: 

  • underdeveloped lungs
  • feeding difficulties
  • vision and hearing issues
  • cerebral palsy
  • stillbirth

For the birthing person

Untreated preeclampsia may cause the following health issues in the birthing person before and after giving birth: 

  • placental abruption
  • pregnancy loss
  • stroke
  • eclampsia, which are seizures that result from high blood pressure
  • permanent kidney and organ damage
  • long term high blood pressure

What are treatments for preeclampsia?

Treatment for preeclampsia focuses on evaluating the progression of preeclampsia with the health of the birthing person and the fetus.

Medications

Doctors may recommend medications to manage symptoms and reduce the risk of complications. These medications include:

  • low-dose aspirin, which doctors may recommend as a preventive measure in pregnant people with moderate to high risk of preeclampsia
  • blood pressure medication to treat hypertension
  • antiseizure medication, such as magnesium sulfate, to reduce the risk of seizures due to high blood pressure (eclampsia)
  • corticosteroids to accelerate lung development in the fetus if premature birth may be a risk

Your OB-GYN will review all medications with you and discuss the benefits, risks, and potential side effects.

Hospitalization and labor induction

If preeclampsia symptoms become severe, doctors may recommend hospitalization to monitor the pregnant person and fetus.

In cases when the pregnant parent and fetus are stable, doctors will typically wait until week 37 to induce labor. This allows time for the fetus’s lungs to develop.

If symptoms are worsening — for the pregnant person, the fetus, or both — doctors may need to induce labor sooner. If possible, they may administer corticosteroids to help speed up lung development in the fetus.

People with preeclampsia can have vaginal deliveries. If complications develop during labor, cesarean delivery may be necessary.

Other frequently asked questions

These are other questions people often ask about preeclampsia. The answers have been reviewed by Stacy A. Henigsman, D.O.

Can a baby survive preeclampsia?

Most cases of preeclampsia result in the delivery of a healthy infant. In cases when preeclampsia symptoms become severe before week 37 of gestation, doctors may need to induce a premature delivery.

Infants born preterm have a higher risk of complications and may require neonatal intensive care.

How does preeclampsia cause death?

Preeclampsia increases the risk of many serious conditions that can become fatal. These include stroke, pulmonary edema, blood clotting disorders, kidney failure, and liver failure.

Can a mother survive preeclampsia?

With proper diagnosis and treatment, most pregnant people have a healthy delivery with preeclampsia. In severe cases when preeclampsia symptoms progress quickly, there is a higher risk of complications or possibly death in the birthing parent.

Is preeclampsia more common with boys or girls?

Some research has shown that preeclampsia is more common when the fetus is female. However, researchers are unclear as to why.

Summary

Preeclampsia a serious pregnancy complication marked by high blood pressure and elevated protein in the urine.

Certain risk factors play a role, including a previous pregnancy with preeclampsia. People in certain ethnic or racial groups — particularly non-Hispanic Black females — have a higher incidence of preeclampsia.

Talk with your OB-GYN about your risk factors for preeclampsia and steps you can take to manage your risk.

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Medical Reviewer: Stacy A. Henigsman, DO
Last Review Date: 2022 May 31
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