Early in your pregnancy, your doctor will ask lots of questions about your health, and perform routine tests to check for risks to you or your developing baby. If they think your pregnancy could be at a higher-than-usual risk for complications, they’ll connect you with specialists to guide you through the rest of your pregnancy.

You’ll spend more time at the doctor’s office than you would otherwise. But you’ll also receive the support and expertise you need. Neonatologist David Sink, MD, explains. 

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What causes a high-risk pregnancy?

There are lots of possible factors. Many are quite common.

Not all women with the following conditions will have a high-risk pregnancy, but these are some common causes.

  • Age 35 or older
  • Being pregnant with twins, triplets or other multiples
  • Certain pre-existing conditions, like high blood pressure, lupus, or thyroid disease
  • Sexually transmitted diseases (STDs)
  • Diabetes, either before becoming pregnant or during pregnancy (gestational diabetes)
  • Pre-eclampsia, a condition that develops during pregnancy
  • Obesity, which can increase a woman’s risk of developing diabetes, hypertension and pre-eclampsia during pregnancy
  • Using cigarettes, alcohol or illegal drugs during pregnancy
  • Genetic risks that run in the family, like sickle cell disease or cystic fibrosis
  • Anomaly in the developing baby, like certain birth defects

What happens once a pregnancy is labeled “high risk”?

With the right care, many high-risk pregnancies result in a normal, healthy pregnancy and delivery. But it’s important for you to be closely monitored, and you may have special health instructions.

Your doctor might refer you to specialists at the Fetal Care Center at Connecticut Children's to guide you through all this.

Will I have any special tests?

You may have frequent prenatal ultrasounds. Your doctors may recommend other tests like:

  • Fetal echocardiogram to check for congenital heart disease or other heart abnormalities in the fetus
  • Fetal heart rate monitoring, also known as a nonstress test or NST
  • Prenatal cell-free DNA screening
  • Genetic screening using amniocentesis or chorionic villus sampling (CVS)
  • Lab tests for urine and blood

Which specialists will I meet?

This can be different for every pregnancy. But here are some of the possibilities.

  • Maternal-fetal medicine specialist: Also called an MFM or perinatologist, these experts have special training in treating medical complications related to pregnancy. Often, this is the first expert you’ll be referred to if your pregnancy may be high risk.
  • Genetic specialist: These experts perform and interpret genetic testing, which can identify the likelihood of parents passing a genetic disease or disorder to their children.
  • Fetal cardiologist: These doctors specialize in diagnosing and caring for congenital heart disease or other heart abnormalities in a fetus.
  • Newborn experts: If your baby will need to stay in a neonatal intensive care unit (NICU), you can meet the doctors who will be leading their care, take a tour of the NICU, and more.
  • Pediatric surgeon: If your baby will require a planned surgery, you’ll meet with the surgical team to talk about their care plan.  
  • Access to support groups and social workers: Your care team can connect you with resources for every aspect of your pregnancy, including emotional support.

>Related: You're Not Alone. Ways to Cope With a High-Risk Pregnancy. 

Bottom line: You and your family will have lots of support throughout your pregnancy. Connecticut Children’s provides more than 30 pediatric specialties for even the tiniest babies – and through our Care Alliances with adult health systems, we coordinate everything with your labor and delivery teams for a seamless care experience.

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