A recent CDC report found cases of high blood pressure in pregnant women rose 73% overall nationally between 2016 to 2024.
High blood pressure is associated with serious complications for both mother and baby. But the CDC report does not specify a cause.
KERA’s Sam Baker talked about the report with Dr. Marc Wilson, an OB-GYN at Texas Health Denton, who had some thoughts of his own about possible causes.
Dr. Wilson: It has to be something environmental, something external.
Some doctors are hypothesizing that it could be microplastics, which can be chemicals and plastics that we're exposed to, everything from our detergents to things that we drink. Also, the processed foods potentially out there.
We are having a lot of women that are delaying having pregnancies, and so you have an advanced maternal age factor, and also reproductive endocrinology, meaning you have a lot of patients that are having in vitro pregnancies and vitro fertilization, and that has also been associated with having hypertensive disorders during pregnancy.
Baker: Who's most at risk for high blood pressure during pregnancy?
Dr. Wilson: Certainly the extremes of ages. So, when you have someone who's very young, like a teenage pregnancy 16, 17 year old, all the way to the other extreme of a patient that's over 35.
If you have a previous history of chronic hypertension, that patient is extremely at risk for having a preeclampsia and the hypertensive conditions that we tend to see that are affecting pregnancy.
Patients that have multiple gestations. If you have twins, that can certainly be a risk factor.
Women that are overweight with an elevated BMI, they're at risk for hypertensive issues during pregnancy, and also women during their first pregnancy. Whether you're Black, White, Hispanic, if it's your first pregnancy, those patients are at risk.
And then the last thing I could think about is women that have diabetes or chronic conditions like kidney disease or autoimmune conditions like, say, lupus. Those patients are certainly at a higher risk for developing hypertensive issues during pregnancy.
Baker: What warning signs would you say expectant mothers should never ignore?
Dr. Wilson: Many times, they don't have any symptoms. I remember I had a patient who really felt fine and she came in during her prenatal appointment and her blood pressure is 180 over 100. And you know, normal blood pressure's 120 over 80.
But if you think about actual symptoms people can perceive, one would be a persistent headache. Anytime that blood pressure is extremely high, they can have a very consistent and persistent headache.
Other times they can have visual changes like blurred vision and also seeing spots.
Many times, too, we can see swelling in the face and the hands. Some of the patients can get right upper quadrant pain because with this whole disease process they can have an injury to the liver and it can cause pain in their right upper quadrant where the liver is located.
And then also, if they have any severe swelling, or quick weight gain that can be one of the signs and also shortness of breath.
Baker: What steps can or should women take before and during pregnancy to help reduce risk of high blood pressure?
Dr. Wilson: First, see their doctor before they even get pregnant, and then the doctor can go over a health plan for them with respect to having a healthy weight and also taking their medications as directed, doing things like increasing hydration, exercise, making sure that they promote a healthy lifestyle.
You want to make sure they are going to all their prenatal visits, and during those visits, they're having their blood pressure taken, and just doing those little simple things, and ultimately that will lead to a positive outcome with respect to their pregnancy.
Baker: During pregnancy, if high blood pressure comes along, can it be treated?
Dr. Wilson: Yes, it can. A patient who has blood pressure issues before 20 weeks, we can get them on medication. Also, impacting this whole process is the use of low dose aspirin. That's had a significant decrease in the reduction of hypertensive conditions during pregnancy.
Once a patient, if she's beyond 20 weeks, and you have blood pressure issues, many times we can start them on an anti-hypertensive medication that's safe to take during pregnancy.
Other treatment options that we cut back on their work and getting off their feet, modify bed rest, and certainly decreasing their salt intake and increasing their hydration.
RESOURCES:
High Blood Pressure During Pregnancy
Rates of high blood pressure Are Rising in Pregnant Women, Study Finds
Trends and Characteristics in Gestational Hypertension: United States, 2016–2024
