Should high blood pressure remain unaddressed during pregnancy, it poses substantial health risks to both the expectant mother and the child. Proactive health management, including vigilant monitoring and adopting healthier lifestyle practices, can help mitigate the risk of complications associated with high blood pressure.
Referred to as gestational hypertension, high blood pressure that emerges during pregnancy is classified when levels reach or exceed 140/90 mm Hg. It stands as a significant medical concern for a number of pregnant individuals.
Though managing high blood pressure effectively during pregnancy can neutralize its threat, failure to do so may induce critical health issues for both the mother and the unborn child. Data from the Centers for Disease Control and Prevention (CDC) suggest that approximately 6-8% of pregnant women aged 20 to 44 in the United States experience gestational hypertension.
High blood pressure during pregnancy, known as gestational hypertension, can be attributed to a variety of factors.
These encompass:
- Excess body weight or obesity
- Sedentary lifestyle
- Tobacco usage
- Alcohol consumption
- Experiencing a first pregnancy
- A family history of hypertension during pregnancy
- Multiple gestation
- Advanced maternal age (over 35 years)
- Utilization of assistive reproductive technologies, such as IVF
- Pre-existing diabetes or specific autoimmune conditions
Risk Factors for Elevated Blood Pressure in Pregnancy
There are certain elements that can heighten the risk of developing high blood pressure during pregnancy.
Lifestyle Concerns:
Unhealthy lifestyle habits are key contributors to high blood pressure in expectant mothers, particularly those involving excess weight or a lack of physical activity.
Pregnancy Details:
First-time mothers are more susceptible to high blood pressure, although the risk diminishes with subsequent pregnancies. Multiple births also increase the workload on the mother’s body, potentially leading to hypertension.
Assisted Reproductive Technologies:
Per the American Society for Reproductive Medicine, methods like IVF may elevate the risk of high blood pressure in pregnant individuals.
Maternal Age:
The risk of high blood pressure escalates for pregnant individuals over the age of 35.
Pre-existing Conditions:
Those with pre-pregnancy hypertension are more at risk of complications during pregnancy compared to those with normal blood pressure levels.
There are three categories of blood pressure conditions related to pregnancy
Chronic Hypertension
Chronic hypertension refers to high blood pressure that exists prior to pregnancy. Women with preexisting hypertension may need to manage it with medication. High blood pressure diagnosed within the first 20 weeks of pregnancy also falls under this category.
Gestational Hypertension
This condition occurs when high blood pressure develops after the 20th week of pregnancy. It typically resolves post-delivery, however, if diagnosed before the 30th week, it may increase the risk of progressing into preeclampsia.
Chronic Hypertension with Superimposed Preeclampsia
Women with chronic hypertension can develop preeclampsia during pregnancy, which is characterized by the presence of protein in the urine or other complications.
Monitoring Blood Pressure in Pregnancy
Blood pressure is recorded as two numbers: systolic pressure over diastolic pressure.
Systolic pressure, the upper number, measures the force on arteries during a heartbeat. Diastolic pressure, the lower number, measures the pressure in arteries when the heart is resting between beats.
Determining Your Baseline Blood Pressure in Pregnancy
Identifying a “normal” blood pressure range during pregnancy begins with establishing a baseline measurement at your initial prenatal appointment. Subsequent checks at each visit will monitor changes.
Typically, a blood pressure reading below 120/80 mm Hg is considered within the normal range.
Understanding High Blood Pressure in Pregnancy
Concern arises when blood pressure readings exceed 130/90 mm Hg, or if the systolic (top) number rises 15 points above your pre-pregnancy baseline. A consistent reading of 140 mm Hg or higher for systolic, and 90 mm Hg or higher for diastolic, defines high blood pressure during pregnancy.
Interestingly, a woman’s blood pressure may decrease early in pregnancy – between 5 weeks and the midpoint of the second trimester – due to hormonal effects which cause blood vessels to dilate, lowering resistance to blood flow.
Recognizing Low Blood Pressure in Pregnancy
Low blood pressure doesn’t have a strict numerical definition during pregnancy, but it may be signaled by symptoms such as headaches, dizziness, nausea, fainting sensations, or cold, clammy skin.
Pregnancy-Induced Blood Pressure Shifts
Throughout pregnancy, blood pressure levels can fluctuate back to pre-pregnancy readings. This can occur due to:
- A significant 45 percent increase in blood volume, as cited by Circulation, requiring the heart to pump more vigorously.
- The heart’s left ventricle enlarging and thickening, aiding in the heightened blood flow.
- An elevation in vasopressin released by the kidneys, leading to water retention.
Postpartum, blood pressure is likely to reduce, but if it remains high, medical intervention with medication may be necessary.
Tips for Monitoring Your Blood Pressure While Pregnant
In addition to in-clinic check-ups, tracking your blood pressure at home is feasible:
- Purchase an arm or wrist blood pressure monitor from pharmacies or online.
- To ensure accuracy, compare its readings with those taken by a healthcare provider.
- Utilize public blood pressure machines available at certain stores.
- For consistency, measure your blood pressure at the same daily interval, in a seated position, legs uncrossed, using the same arm.
Any consistent high readings or symptoms indicative of elevated blood pressure should be promptly communicated to your healthcare provider.
Mitigating High Blood Pressure During Pregnancy
To avert the risk of high blood pressure during pregnancy, addressing key risk factors such as obesity with targeted dietary choices and regular physical activity is crucial.
Weight gain is an expected aspect of pregnancy, but concerns about it should be discussed with your healthcare provider to establish an ideal target and strategies for maintaining a healthy range.
Nutritional recommendations for expecting mothers are tailored to individual needs. Consulting with a dietician can lead to a personalized nutrition plan corresponding to one’s height and weight requirements.
It is critical to abstain from smoking and consuming alcohol as they not only elevate blood pressure but also present additional health risks during pregnancy.
Regarding salt intake, moderation is key. While over-restricting salt can be detrimental and impede fetal health, maintaining an appropriate balance is recommended, even for those managing elevated blood pressure.
Hormonal fluctuations and the array of psychological and physiological changes experienced during pregnancy can exacerbate stress levels, potentially complicating the management of high blood pressure. Engaging in stress-relieving practices such as yoga or meditation may offer significant benefits.
Medications for Controlling Hypertension in Pregnancy
Certain standard antihypertensive drugs may pose risks during pregnancy. Medications such as ACE inhibitors, renin inhibitors, and angiotensin receptor blockers are generally avoided since they can cross into the placenta and negatively affect fetal development.
However, medications like Methyldopa and Labetalol are deemed safe for controlling blood pressure during pregnancy and are often the recommended treatment to ensure maternal and fetal well-being.