What is preeclampsia? Who is most at risk? What should we be aware of?

Reproductive Health

Preeclampsia and other severe pregnancy complications, especially among Black people, have thankfully been getting more attention in the media in the last couple of weeks.

These individual stories are so important because they humanize what can sometimes become numbing statistics. And they are highlighting some of the significant health disparities in the U.S. that Black families face.

So let’s take this as an opportunity to learn more:

What is preeclampsia?

Preeclampsia is a complication of pregnancy (and sometimes of the postpartum period, too!) that causes an increase in blood pressure and can affect many organ systems; your heart, liver, kidney, and lungs can all be affected if left untreated.

It occurs in 4–8% of all pregnancies, and in rare cases, it can become severe. If this happens suddenly or is not recognized, it can lead to serious harm to those who are pregnant and their unborn babies.

Who is most at risk?

Preeclampsia affects approximately 1 in 25 pregnancies in the U.S., with rates increasing in recent years. Worldwide, it is one of the leading causes of pregnancy-related and newborn death.

❗In the U.S., Black people are at the highest risk (3-4 times higher than white people), with U.S.-born Black people at even higher risk than Black people born outside of the US, but living here at the time of their pregnancy. This shows that there is more than just race as a factor.

What can we (all of us) do to lower the rates of illness and death from preeclampsia, especially among Black families?

While preeclampsia can be scary, when it is identified and treated, the risks of severe disease are decreased.

💥For many who develop preeclampsia, there are NO signs that can be identified easily at home.

💥💥This is why ACCESS to *culturally humble* PRENATAL CARE, including transportation, child care during appointments, and help with other barriers, is so critical to pregnant families. It is at prenatal care visits that most cases of preeclampsia are first identified.

The following is a list of some of the signs and symptoms that may occur when preeclamsia worsens. Again, you may not experience or know you are experiencing (rising blood pressure, for example) any of these, so always keep your appointments and never hesitate to call your healthcare team in between appointments if you are worried or just don’t feel right.

🔴 Rising blood pressure. If you are given a cuff to use at home, ask your clinician what readings should prompt a call to the office or on-call staff. In general, you should call your practitioner or be evaluated in person if your blood pressure goes above 140 for the top number or 90 for the bottom number.

🔴 Changes or blurred spots in your vision that don’t go away quickly

🔴 Severe headaches

🔴 Trouble breathing

🔴 Right-sided pain under your lower ribs or severe heartburn

🔴 Sudden increase in swelling, particularly in the face or hands. While gradual swelling can be normal in pregnancy, if it seems sudden or extreme this can be a sign of preeclampsia.

Any of these signs or symptoms require TWO things:

1) an urgent call to your clinical team AND

2) your clinical team *acting* on your concerns. If you ever feel that your concerns aren’t being acted on, you can ask for a second opinion or go to a hospital for evaluation.

❗❗As noted before, it is important remember that preeclampsia can happen *after* you give birth as well, so if any of these symptoms happen to you or your loved one after giving birth, call your clinical team.

*Also, there is increasing evidence that long-term blood pressure and heart issues may continue in people with a history of preeclampsia even many years later, so following up with your primary care team is important. Keep everyone in the loop!

Read more about Black reproductive health here.

Stay safe, stay well.

Those Nerdy Girls

References and Resources:

Nativity-Related Disparities in Preeclampsia and Cardiovascular Disease Risk Among a Racially Diverse Cohort of US Women

U.S.-Born Black Women at Higher Risk of Preeclampsia than Foreign-Born Counterparts; Race Alone Does Not Explain Disparity

Cultural Humility in Healthcare

What is preeclampsia?

Preeclampsia and Eclampsia

Black pregnant people are at higher risk for preeclampsia:

How Black women can take control of their blood pressure

Factors contributing to higher incidence of diabetes for black Americans

Race, Ethnicity, & Kidney Disease

The Black Maternal Health “Momnibus” Bill in the U.S. House of Representatives

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