Regular prenatal visits help the health care provider identify potential health problems early and take steps to manage them, to protect the health of the mother and the developing fetus. Being aware of the symptoms of these conditions and getting regular prenatal care can prevent health problems and help you get treatment as early as possible.
These problems include:1
Anemia occurs when your red blood cell count (hemoglobin or hematocrit) is low. Iron deficiency anemia is the most common type of anemia. Iron is part of the hemoglobin that allows blood to carry oxygen. Pregnant women need more iron than normal for the increased amount of blood in their body and for their developing child.2 Symptoms of iron deficiency include feeling tired or weak, looking pale, feeling faint, or experiencing shortness of breath. Your health care provider may recommend iron and folic acid supplements.3
Gestational diabetes occurs when blood sugar levels are found to be too high during pregnancy. The exact number of women affected by gestational diabetes is unknown because of different diagnostic criteria and risk profiles.4 Most often the condition is discovered using a two-step procedure: screening with the glucose challenge screening test around 24 to 28 weeks of pregnancy, followed by a diagnostic test called the oral glucose tolerance test. Gestational diabetes increases the risk of a baby that is too large (macrosomia), preeclampsia (pronounced pree-i-KLAMP-see-uh, a condition marked by a sudden increase in a pregnant woman's blood pressure along with the presence of protein in the urine after the 20th week of pregnancy), and cesarean birth. Treatment includes controlling blood sugar levels through a healthy diet and exercise, and through medication if blood sugar values remain high.5
Many people are familiar with the phrase "postpartum depression," meaning depression that occurs after the birth of a baby. But we now know that it's not just during the postpartum period, and it's not just depression.
Women experience depression and anxiety, as well as other mental health conditions, during pregnancy and after the baby is born. These conditions can have significant effects on the health of the mother and her child.
The NICHD-led Moms' Mental Health Matters initiative is designed to educate consumers and health care providers about who is at risk for depression and anxiety during and after pregnancy, the signs of these problems, and how to get help. The initiative also includes Information for Partners, Family, and Friends on ways to help.
There is no single cause of depression or anxiety during and after pregnancy, but hormonal changes, stress, family history, and changes in brain chemistry or structure may all play a role.6 Women who have complications during pregnancy are at higher risk for postpartum depression than are women who do not have complications.7
Depression can harm the developing fetus if you do not take care of yourself during pregnancy, including attending regular prenatal visits and avoiding alcohol and tobacco smoke. Talk to your health care provider if you feel overwhelmed, sad, or anxious. Even though they are serious conditions, depression and anxiety are treatable.
Possible problems in the fetus include decreased movement after 28 weeks of pregnancy and being measured as smaller than normal. These pregnancies often require closer follow-up including more testing such as ultrasound exams, non-stress testing and biophysical profiles as well as possible early delivery.
Pregnant women who develop high blood pressure will need to be monitored closely for preeclampsia.
Infections, including some sexually transmitted infections (STIs), may occur during pregnancy and/or delivery and may lead to complications for the pregnant woman, the pregnancy, and the baby after delivery. Learn more about how infections can affect pregnancy and which infections can cause problems during pregnancy. For the latest information on COVID-19 and pregnancy, visit CDC at https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/pregnant-people.html.
(Pronounced HEYE-pur-EM-uh-suhss grav-uh-DAR-uhm). Some women experience severe, persistent nausea and vomiting during pregnancy beyond the typical "morning sickness." Medication may be prescribed to help with the nausea. Women with hyperemesis gravidarum may need hospitalization to get the fluids and nutrients they need through a tube in their veins. Often, the condition lessens by the 20th week of pregnancy.
Pregnancy loss from natural causes before the 20th week is considered a miscarriage. It is hard to estimate exactly how many pregnancies end in miscarriage because they may occur before a woman even knows she is pregnant.8 The most common cause of first trimester miscarriage is chromosomal problems. Symptoms can include cramping or bleeding. Spotting early in pregnancy is common and does not mean that a miscarriage will occur.
This condition occurs when the placenta covers part of the opening of the cervix inside the uterus. It can cause painless bleeding during the second and third trimesters. The health care provider may recommend bed rest. Hospitalization may be required if bleeding is heavy or if it continues. Placental problems may affect how the baby is delivered.
In some women, the placenta separates from the inner uterine wall. This separation, or abruption, can be mild, moderate, or severe. If severe, the fetus cannot get the oxygen and nutrients needed to survive. Placental abruption can cause bleeding, cramping, or uterine tenderness. Treatment depends on the severity of the abruption and how far along the pregnancy is. Severe cases may require early delivery.
Preeclampsia is a quick or sudden onset of high blood pressure after the 20th week of pregnancy. This condition causes high blood pressure, swelling of the hands and face, abdominal pain, blurred vision, dizziness, and headaches. In some cases, seizures can occur—this is called eclampsia (pronounced ih-KLAMP-see-uh). The only definite cure for preeclampsia and eclampsia is to deliver the baby. If this would result in a preterm birth, then the maternal and fetal risks and benefits of delivery need to be balanced with the risks associated with the infant being born prematurely.
Infants do best if they are born after 39 or 40 weeks of pregnancy (full term). The fetus's lungs, liver, and brain go through a crucial period of growth between 37 weeks and 39 weeks of pregnancy.
Going into labor before 37 weeks of pregnancy is a major risk factor for complications for the infant and for future preterm births for the mother. Sometimes, when there is a health risk to the mother or baby, planned deliveries before 39 weeks are necessary. However, in a healthy pregnancy, it's best to wait until at least 39 weeks. Learn more about why it's worth it to wait until at least 39 weeks to deliver for healthy pregnancies.
Citations
- Centers for Disease Control and Prevention. (2015). Pregnancy Complications. Retrieved January 6, 2016, from http://www.cdc.gov/reproductivehealth/
maternalinfanthealth/pregcomplications.htm - National Institutes of Health Office of Dietary Supplements. (2015). Dietary supplement fact sheet: Iron. Retrieved January 6, 2016, from https://ods.od.nih.gov/factsheets/Iron-HealthProfessional/
- MedlinePlus. (2015). Iron deficiency anemia. Retrieved January 6, 2016, from
http://www.nlm.nih.gov/medlineplus/ency/article/000584.htm - DeSisto, C. L., Kim, S. Y., & Sharma, A. J. (2014). Prevalence estimates of gestational diabetes mellitus in the United States, Pregnancy Risk Assessment Monitoring Systems (PRAMS), 2007–2010. Preventing Chronic Disease, 11, E104.
- NICHD. (2012). Fact sheet: Am I at risk for gestational diabetes? NIH Publication No. 12-4818. Retrieved January 6, 2016 from https://www.nichd.nih.gov/publications/pubs/Documents/gestational_diabetes_2012.pdf (PDF 187 KB)
- Womenshealth.gov. (2012). ePublications: Depression during and after pregnancy fact sheet. Retrieved January 6, 2016, from http://www.womenshealth.gov/publications/our-publications/fact-sheet/depression-pregnancy.html
- Milgrom, J., Gemmill, A. W., Bilszta, J. L., Hayes, B., Barnett, B., Brooks, J., et al. (2008). Antenatal risk factors for postnatal depression: A large prospective study. Journal of Affective Disorders, 108(1–2), 147–157.
- MedlinePlus. (2014). Miscarriage. Retrieved January 6, 2016, from http://www.nlm.nih.gov/medlineplus/ency/article/001488.htm
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