Am I at Risk for Preeclampsia? An OB/GYN Explains Risk Factors

Preeclampsia can happen in any pregnancy, including pregnancies without an obvious warning sign. But some medical conditions, pregnancy characteristics, and personal-history factors make it more likely.

In this short video, I explain which factors place someone at higher risk—and why having a risk factor does not mean you will develop preeclampsia.

Watch: Am I at Risk for Preeclampsia? OB/GYN Explains Risk Factors

What is preeclampsia?

Preeclampsia is a serious pregnancy-related blood pressure disorder that can affect multiple organs. It most often develops after 20 weeks of pregnancy, but it can also occur after delivery.

One challenging part of preeclampsia is that it can sometimes develop without noticeable symptoms. This is one reason your blood pressure is checked at every prenatal appointment.

What are the high-risk factors for preeclampsia?

According to the American College of Obstetricians and Gynecologists (ACOG), factors that can place someone in a high-risk category include:

• Preeclampsia in a previous pregnancy
• Carrying twins, triplets, or more
• Chronic high blood pressure
• Type 1 or type 2 diabetes present before pregnancy
• Kidney disease
• Certain autoimmune conditions, including lupus or antiphospholipid syndrome
• A combination of multiple moderate-risk factors

Having one of these factors does not guarantee that preeclampsia will occur. It does mean your prenatal care team may recommend additional monitoring or discuss preventive strategies with you.

What are the moderate-risk factors?

Moderate-risk factors include:

• Being pregnant for the first time
• Being age 35 or older
• A prepregnancy body mass index over 30
• A mother or sister who had preeclampsia
• More than 10 years since a previous pregnancy
• In vitro fertilization
• Certain complications in a previous pregnancy, such as a baby with a low birth weight
• Black race, because of the effects of racism and health inequities—not a biological difference
• Lower income, because of inequities that can affect health and access to care

A single moderate-risk factor may not change pregnancy management. Having more than one can be more meaningful, which is why the complete picture matters.

Can you develop preeclampsia without any risk factors?

Yes. Risk factors help clinicians identify who may be more likely to develop preeclampsia, but they are not a perfect prediction tool.

You can have several risk factors and never develop it. You can also develop preeclampsia without having a clear risk factor. Keeping prenatal appointments and having your blood pressure checked remain important for everyone.

Should you take low-dose aspirin?

For some pregnant patients at increased risk, low-dose aspirin can reduce the chance of developing preeclampsia and related complications. ACOG and the U.S. Preventive Services Task Force recommend it for certain high-risk patients and advise considering it when multiple moderate-risk factors are present.

Aspirin is not something to start based only on an online checklist. Ask your OB/GYN, midwife, or other prenatal care clinician whether it is appropriate for you, when to begin it, and what dose to use.

Questions to ask at your prenatal visit

If you are unsure about your risk, consider asking:

• Do I have any high- or moderate-risk factors for preeclampsia?
• Does my combination of risk factors change my prenatal monitoring?
• Should I take low-dose aspirin during this pregnancy?
• What blood pressure readings or symptoms should prompt me to call?
• Should I monitor my blood pressure at home?

The bottom line

Preeclampsia risk is not all-or-nothing. One risk factor is not a diagnosis, and having no known risk factors is not a guarantee that it cannot happen.

The useful question is not simply, “Am I at risk?” It is: What does my individual combination of health history and pregnancy factors mean for my care?

That is a conversation worth having early in pregnancy with the clinician who knows your medical history.

Watch the full video on YouTube

Sources and further reading

• ACOG: Preeclampsia and High Blood Pressure During Pregnancy
• ACOG: 7 Things to Know About Preeclampsia
• U.S. Preventive Services Task Force: Aspirin Use to Prevent Preeclampsia

Medical disclaimer: This article is for general educational purposes only and is not medical advice, diagnosis, or treatment. It does not create a physician-patient relationship. Talk with a qualified healthcare professional who knows your individual history. If you have concerning symptoms, an elevated blood pressure reading, or believe you may be experiencing an emergency, seek prompt medical care.