How to Prevent Preeclampsia

Preeclampsia, a complication of pregnancy, results in high blood pressure and increased levels of protein in the urine. In some severe cases, preeclampsia can lead to seizures and an increased risk of death.

“The cost of preeclampsia is high, as a leading cause of prematurity, and far-reaching, as patients face lifelong increased rates of cardiovascular disease. Pregnant patients with preeclampsia require specialized care during and after pregnancy to improve pregnancy outcomes and long-term health,” says Louise E. Wilkins-Haug, MD, PhD, a Mass General Brigham obstetrician-gynecologist.

In this article, Dr. Wilkins-Haug shares ways pregnant people can help reduce their risk of preeclampsia and discusses the related dangers, risk factors, and symptoms.

Dr. Wilkins-Haug is division director of Maternal-Fetal Medicine at Brigham and Women’s Hospital and clinical lead at the Brigham’s Center for Connected Postpartum Care, which helps patients optimize their health and reduce long-term risks in the postpartum period.

The Center works closely with Saba Berhie, MD, Ellen Seely, MD, Ann Celi, MD, MPH, and Meghan Rudder, MD, to bring multispecialty care to patients following a pregnancy complicated by high blood pressure. The team focuses on care in the immediate 6 weeks following birth, but also helps patients transition to ongoing care. This ensures patients can help lower their risk of health problems if they plan to get pregnant again.

How do you prevent preeclampsia?

Doctors have known about preeclampsia for many centuries, though its direct causes are unknown. While there’s no way to completely prevent preeclampsia, you can work with your OB/GYN to help reduce your risk.

According to the American College of Obstetricians and Gynecologists (ACOG), taking one or two low-dose aspirins each day starting early in pregnancy may reduce the risk of preeclampsia in some patients. Talk to your OB/GYN before taking any medication to make sure it’s right for you.

Chronic high blood pressure, or hypertension, increases your risk of preeclampsia. ACOG recommends these lifestyle changes to help reduce your risk of high blood pressure:

• Limit salt and eat a heart-healthy diet.
• Exercise regularly.
• Find ways to reduce stress, such as meditation.
• Avoid alcohol.
• Work with your provider to reach a healthy weight if you have overweight or obesity.

Short- and long-term effects of preeclampsia

In some serious cases of preeclampsia, doctors may recommend an early birth, at times requiring C-section, despite the health risks of a premature birth for the baby. Research has found that preeclampsia also has long-term health consequences for the pregnant patient.

Patients with a history of preeclampsia have a 2- to 4-fold increase in the risk of developing high blood pressure and heart disease later in life. For these patients, preeclampsia can serve as a warning, allowing them to take measures to reduce their risk of heart disease.

Preeclampsia risk factors

Although any pregnant person can develop preeclampsia, some people are at a greater risk than others. Risk factors for preeclampsia include:

• Preeclampsia in a previous pregnancy
• Family history of preeclampsia
• Chronic high blood pressure
• Carrying multiples (for example, twins)
• Kidney disease
• Diabetes
• Being pregnant while 35 or older
• Obesity
• Autoimmune diseases like lupus

What are the signs and symptoms of preeclampsia?

Preeclampsia doesn’t always cause symptoms, so it’s important to meet with your OB/GYN as advised to monitor your health. Preeclampsia symptoms usually happen during pregnancy, but some people develop what’s known as postpartum preeclampsia. This usually happens a few days after giving birth, but it could develop up to 6 weeks later.

People who do experience preeclampsia or postpartum preeclampsia symptoms may notice any of the following:

• Changes in vision
• Swelling in feet, hands, or face
• A throbbing headache
• Pain in the stomach, low back, and/or right shoulder
• Sudden weight gain
• Difficulty breathing
• Nausea and/or vomiting

Even if you don’t have clear risk factors for preeclampsia, it’s important not to dismiss these symptoms as normal pregnancy or postpartum changes. Talk to your health care team right away if you experience any of these symptoms, and they can confirm if you may need to meet with your OB/GYN for a checkup. 

Tips to help reduce risk of heart disease after having preeclampsia

The American Heart Association recommends taking action to keep your heart healthy if you’ve had preeclampsia:

• Stop smoking cigarettes.
• Follow a heart-healthy diet.
• Engage in regular physical activity, like walking or strength training.
• Reach and maintain a healthy weight.
• Tell your primary care provider (PCP) about your history of preeclampsia.

Care during and after pregnancy

If you develop preeclampsia, the multidisciplinary team at Brigham and Women’s Hospital can help you manage the condition during pregnancy, the postpartum period, and beyond. They help patients with a history of preeclampsia improve their long-term health and reduce risk of heart disease.

The Brigham team also has expertise in preventing and treating other pregnancy complications, like postpartum depression, heart disease in pregnancy, postpartum hemorrhage or stroke, and more.