Health & Pregnancy

Some Women More at Risk of Pregnancy Problem

March 10, 2005 - Researchers have pinpointed the factors that increase a woman's risk of developing the common pregnancy problem called preeclampsia.

PreeclampsiaPreeclampsia is marked by three specific symptoms: water retention (with swelling particularly in the feet, legs, and hands); high blood pressure; and protein in the urine, a sign of possible kidney damage. All three must be present at the same time.

Symptoms can include swelling, sudden weight gain, persistent headache, vision changes, and vomiting. But some women experience no symptoms at all. Preeclampsia usually appears after 20 weeks of pregnancy.

The only real cure is the birth of the baby. If the baby is not ready to be delivered, bed rest or medication can be used to help allow the baby more time to develop. If left untreated, preeclampsia can develop into eclampsia, a dangerous condition that can cause seizures and coma in the mother and death in the mother and baby.

The review by researchers from Oxford, England's John Radcliffe Hospital is one of the first to attempt to quantify risk factors for preeclampsia, a condition that complicates as many as one in eight pregnancies and is a leading cause of maternal and infant death and premature birth.

Women who have had preeclampsia before have a sevenfold higher risk for developing the potentially life-threatening condition in subsequent pregnancies.

"These findings show the importance of following pregnant women closely if they have had preeclampsia in the past," lead researcher Kirsten Duckitt, MD, tells WebMD.

"The thinking has been that this is not such a big concern and that women with a previous preeclampsia will be fine. But it is clear that these women need to be watched closely."

In addition to having had preeclampsia before, the researchers found that several other factors increase the risk of developing preeclampsia.

• Women with diabetes are four times as likely to develop preeclampsia.
• Giving birth for the first time triples the risk.
• Carrying more than one child is associated with about a threefold increase in risk.
• A family history of preeclampsia was found to nearly triple the risk.
• Becoming pregnant after age 40 nearly doubled a woman's risk.
• Having high blood pressure prior to pregnancy slightly elevated the risk of developing preeclampsia.
• Being overweight more than doubled risk of preeclampsia.
• Antiphospholipid syndrome, in which women have abnormal antibodies, increased the risk of preeclampsia almost tenfold. The condition has also been linked to an increased risk for miscarriage.

"Clinicians have long known about these risk factors, but I think the strength of some of these associations will surprise some people," University of Glasgow, Scotland, obstetrics and gynecology professor Ian A. Greer, MD, tells WebMD.

In the new review, published in the March 12 issue of the British Journal of Medicine, Duckitt and colleague Deborah Harrington reviewed 52 preeclampsia studies conducted between 1966 and 2002.