HPQ Risk: Current Health and Diagnoses - Weight, Diabetes, and Hypertension
A number of current health factors and diagnoses are associated with an increased risk of preterm birth and other related complications and are included in HPQ.
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This includes:
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having a low or high pre-pregnancy weight (body mass index, BMI, below 18.5 kg/m2 or at or above 30.0 kg/m2)
More detail regarding each of these factors is included below.
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The HPQ does not include all known risk factors for preterm birth and other pregnancy complications. It is critical to be working with a health provider to create a personalized care plan for your own pregnancy that considers factors in and not considered by the HPQ.
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If you have note read our note about Social Determinants of Health and "Mother/Mommy Blaming" please do so.
All of the factors listed and associated risk for preterm birth and other outcomes have potent links to social determinants of health. In no instance should these factors be considered as existing independently of social context. Guilt or shaming plays no role in what we do or in the information we share. We are about strength and empowerment of pregnant people and parents through information sharing.
Low Pre-pregnancy Weight
Low pre-pregnancy weight (Body Mass Index, BMI, below 18.5 kg/m)
Having a low pre-pregnancy weight can increase the risk of preterm birth and other pregnancy complications. Individuals who are underweight before becoming pregnant are more likely to have a premature delivery and to give birth to babies with low birth weight. They may also be at a higher risk of developing gestational diabetes, preeclampsia, and other complications during pregnancy.
Disparities exist in the relationship between low pre-pregnancy weight and pregnancy outcomes. Individuals from low-income backgrounds and from certain racial and ethnic groups, such as those who are Black or Hispanic, are more likely to be underweight before becoming pregnant and to experience preterm birth and other pregnancy complications. These disparities are often linked to differences in access to healthcare, healthy food, and other resources that can impact maternal and fetal health.
The increased risk of preterm birth and other complications in people with a low pre-pregnancy weight is due to various biological mechanisms. People who are underweight before becoming pregnant may not have enough nutritional reserves to support a healthy pregnancy. They may also be more likely to have chronic health conditions, such as anemia or thyroid disorders, that can impact pregnancy outcomes.
To address the increased risk of preterm birth and other pregnancy complications in women with a low pre-pregnancy weight, it is important to be under the care of a health provider throughout pregnancy. Individuals with a low pre-pregnancy weight may need additional nutritional support and may need to gain more weight during pregnancy than those who start off at a higher weight. Improving access to healthy food and resources can also help lower the risk of complications and reduce disparities in maternal and fetal health outcomes.
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If you need food or nutritional assistance you can find help via a number of community-based on other organization that you can find on our help and resources page.
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If present and associated with an increased risk for preterm birth in your race/ethnicity and insurance grouping, this factor will be included in your overall HPQ score. This and other factors affecting your preterm birth risk should be discussed with your prenatal provider.
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If you had a low pre-pregnancy weight, creating a Healthy Pregnancy Plan through EGG HP can help you create a plan for managing your risk and talking about your results with your provider.
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Related links -
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- Publications by EGG HP and investigators related to having a low pre-pregnancy weight and risk scoring:​
- Pre-pregnancy or first-trimester risk scoring to identify women at high risk of preterm birth
- Replication of pre-pregnancy or first-trimester risk scoring to identify women at high risk of preterm birth
- Other related publications:
High Pre-pregnancy Weight
High pre-pregnancy weight (Body Mass Index, BMI, at or above 30.0 kg/m)
Preterm birth and obesity are two health issues that are related, and research has shown that there is a higher risk of preterm birth in those with a pre-pregnancy BMI at or above 30.0 kg/m (the cut point generally referred to as being in the "obese" range). Having a BMI in this range is generally characterized by having excess body fat, and it is associated with a higher risk of various health problems, including diabetes and hypertension during pregnancy.
There are some observed race/ethnic disparities in preterm birth and having a high BMI. Black and Latina/Latinx/Hispanic mothers are more likely to have a preterm birth than white mothers, and they are also more likely to have a BMI of 30 or more. This disparity is likely due to a combination of factors, including differences in access to healthcare, socioeconomic status, and cultural factors.
Several known causes have been identified for the link between preterm birth and having a high pre-pregnancy BMI. One possible explanation is that people with a high BMI may be more likely to have diabetes or high blood pressure, which are risk factors for preterm birth. Pregnant people may also have hormonal imbalances that can affect their pregnancy, and they may be more likely to experience complications such as pre-eclampsia or gestational diabetes.
There are interventions that can help reduce the risk of preterm birth in women who are obese. Losing weight before getting pregnant can help reduce the risk of preterm birth and other pregnancy complications. Other interventions include improving nutrition, managing diabetes or high blood pressure, and getting regular prenatal care. It is important for women who are obese to work closely with their healthcare provider to develop a plan that is safe and effective for them and their baby.
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If you need access to healthy food or nutritional assistance you can find help via a number of community-based on other organization that you can find on our help and resources page.
​
If present and associated with an increased risk for preterm birth in your race/ethnicity and insurance grouping, this factor will be included in your overall HPQ score. This and other factors affecting your preterm birth risk should be discussed with your prenatal provider.
​
If you had a high pre-pregnancy weight, creating a Healthy Pregnancy Plan through EGG HP can help you create a plan for managing your risk and talking about your results with your provider.
​
Related links -
​​​
- Publications by EGG HP and investigators related to having a high pre-pregnancy weight and risk scoring:​
- Pre-pregnancy or first-trimester risk scoring to identify women at high risk of preterm birth
- Replication of pre-pregnancy or first-trimester risk scoring to identify women at high risk of preterm birth
Expected age at delivery more than 34-years of age
Being more than 34-years of age at delivery is consistently reported as a risk factor for preterm birth.
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Of note, data suggests that the association between increased risk for preterm birth in those over 34-years of age can differ greatly depending how much older than 34-years of age you are. It is important to be working with a prenatal provider to discuss how these factors relate to your own pregnancy.
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While it is not well understood why individuals who are more than 34-years of age at the time of delivery are at increased risk of preterm birth, some data suggests that this may be related to earlier inductions of labor due to the presence of other risk factors. There are also some changes to the uterus and endocrine systems that occur with age that have been suggested to play a role.
While data is lacking on how specific interventions may help reduce the risk of preterm birth and other adverse outcomes in pregnant people with an age at delivery above 34-years, it is important to be aware that whether or not you have other risk factors present or absent will greatly affect your overall risk. Being aware of and managing those risks is important. The HPQ can help you identify these factors. Our Healthy Pregnancy Planning tool may also be a helpful for outlining how you want to manage your pregnancy in partnership with your prenatal provider.
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For pregnant people with an age at above 34-years, low dose aspirin is a recommended treatment to reduce your risk of preeclampsia and related conditions like preterm birth when accompanied by other "moderate" risk factors (see our overview about recommendations for low-dose aspirin use HERE).
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If you will be more than 34-years if birth at the time of expected delivery then this factor will be included in your overall HPQ score. This and other factors affecting your preterm birth risk should be discussed with your prenatal provider.
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If you are completing a HELLO EGG Healthy Pregnancy Plan and will be more than 34-years of age at the time of expected delivery, it will be important to note how you plan to manage and address this risk with your provider.
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Related links -
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- Publications by EGG HP and investigators related to age at delivery more than 34-years and risk scoring:​
- Pre-pregnancy or first-trimester risk scoring to identify women at high risk of preterm birth
- Replication of pre-pregnancy or first-trimester risk scoring to identify women at high risk of preterm birth
​Read More -
Aspirin Use to Address Risk
HPQ Risk: Pregnancy History
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HPQ Risk: Demographic Factors
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HPQ Risk: Current Health and Diagnoses - ​
​Weight, Diabetes, and Hypertension
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Other Conditions and Infection
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Wellness and Care
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Exposures
Less than 12-years of education
Having less than 12-years of education is often reported as a risk factor for preterm birth.
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While it is not well understood why some individuals with less than 12-years of education are at increased risk for preterm birth, it is mostly believed that this risk is related to other factors that can sometimes co-occur with having less eduction like having fewer resources, less optimal health care, and experiencing higher levels of stress.
While data is lacking on how specific interventions may help reduce the risk of preterm birth and other adverse outcomes in pregnant people with less than 12-years of education, it is important to be aware that whether or not you have other risk factors present or absent will greatly affect your overall risk. Being aware of and managing those risks is important. The HPQ can help you identify these factors. Our Healthy Pregnancy Planning tool may also be a helpful for outlining how you want to manage your pregnancy in partnership with your prenatal provider.
​
For some pregnant people, including, for example, low income people (a factor which is sometimes closely associated with less than 12-years of education), low dose aspirin is a recommended treatment to reduce the risk of preeclampsia and related conditions like preterm birth when accompanied by other "moderate" risk factors (see our overview about recommendations for low-dose aspirin use HERE).
​
If you have less than 12-years of education at the time of expected delivery then this factor will be included in your overall HPQ score. This and other factors affecting your preterm birth risk should be discussed with your prenatal provider.
​
If you are completing a HELLO EGG Healthy Pregnancy Plan and have less than 12-years of education, it will be important to note how you plan to manage and address this risk with your provider.
​
Related links -
​​​
- Publications by EGG HP and investigators related to years of education and risk scoring:​
- Pre-pregnancy or first-trimester risk scoring to identify women at high risk of preterm birth
- Replication of pre-pregnancy or first-trimester risk scoring to identify women at high risk of preterm birth
- Other related publications: