2.10: Complications of Pregnancy

There are a number of common side effects of pregnancy. Not everyone experiences all of these, nor to the same degree. And although they are considered "minor", this is not to say that these problems are not potentially very uncomfortable. These side effects include nausea (particularly during the first 3-4 months of pregnancy as a result of higher levels of estrogen in the system), heartburn, gas, hemorrhoids, backache, leg cramps, insomnia, constipation, shortness of breath or varicose veins (as a result of carrying a heavy load on the abdomen). These are minor issues.

But there are also serious complications of pregnancy which can pose health risks to biological parent and child and that often require hospitalization.

Hyperemesis gravidarum is characterized by severe nausea, vomiting, weight loss, and possibly dehydration. Signs and symptoms may also include vomiting many times a day and feeling faint. The exact causes of hyperemesis gravidarum are unknown. Risk factors include the first pregnancy, multiple pregnancy, obesity, prior or family history of HG, trophoblastic disorder, and a history of eating disorders. Treatment includes drinking fluids and a bland diet. Medication, intravenous fluids, and hospitalization may be required. Hyperemesis gravidarum is estimated to affect 0.3–2.0% of pregnant people. Those affected have a low risk of miscarriage but a higher risk of premature birth.

Ectopic Pregnancy occurs when the zygote becomes attached to the fallopian tube before reaching the uterus. About 1 in 50 pregnancies in the United States are tubal pregnancies and this number has been increasing because of the higher rates of pelvic inflammatory disease and Chlamydia (Carroll, 2007). Abdominal pain, vaginal bleeding, nausea and fainting are symptoms of ectopic pregnancy.

Figure \(\PageIndex{1}\): When the zygote fails to travel down the fallopian tube into the uterus and instead lodges in the fallopian tube and continues to grow there, it is called an ectopic pregnancy.[1]

Spontaneous abortion is experienced in an estimated 20-40 percent of undiagnosed pregnancies and in another 10 percent of diagnosed pregnancies. Usually the body aborts due to chromosomal abnormalities, and this typically happens before the 12th week of pregnancy. Cramping and bleeding result and normal periods return after several months. Some people are more likely to have repeated miscarriages due to chromosomal, amniotic, or hormonal problems, but miscarriage can also be a result of defective sperm (Carrell et. al., 2003).

Preeclampsia, also known as Toxemia, is characterized by a sharp rise in blood pressure, a leakage of protein into the urine as a result of kidney problems, and swelling of the hands, feet, and face during the third trimester of pregnancy. Preeclampsia is the most common complication of pregnancy. When preeclampsia causes seizures, the condition is known as eclampsia, which is the second leading cause of maternal death in the United States. Preeclampsia is also a leading cause of fetal complications, which include low birth weight, premature birth, and stillbirth. Treatment is typically bed rest and sometimes medication. If this treatment is ineffective, labor may be induced.

Maternal Mortality: Approximately 1000 people die in childbirth around the world each day (World Health Organization, 2010). Rates are highest in Sub-Saharan Africa and South Asia, although there has been a substantial decrease in these rates. The campaign to make childbirth safe for everyone has led to the development of clinics accessible to those living in more isolated areas and training more midwives to assist in childbirth.[2]

What is alarming is the rate of infant and maternal mortality rates among Black individuals in the US. Los Angeles County “Black Infants and Families” found “Black women and Black birthing persons are 3 times more likely to die from pregnancy related complications than their white counterparts,” while American Indian and Alaska Native women were 2.5 times more likely to suffer a pregnancy-related death.[3] These disparities exist even after accounting for socioeconomic differences. For example, Black infant mortality is 3.1 more deaths per 1,000 live births among college educated Black families than infants of White families who have a high school diploma or less. And Black women with at least a college degree have higher severe pregnancy complications than women of other races and ethnicities who did not graduate high school. [4][5]

Attributions:

Child Growth and Development by Jennifer Paris, Antoinette Ricardo, and Dawn Rymond, 2019, is licensed under CC BY 4.0

[1] Image by Takatakatakumi is licensed under CC BY-SA 3.0

[2] Hyperemesis Gravidarum by Wikipedia is licensed under CC BY-SA 3.0

Lifespan Development: A Psychological Perspective (page 58) by Martha Lally and Suzanne Valentine-French is licensed under CC BY-NC-SA 3.0

[3] Black Infants and Families, Los Angeles posted by Brittany Lock, April 11, 2022 via Public Radio Exchange

[4] Fishman, S.H., Hummer, R.A., Sierra, G., Hargrove, T., Powers, D.A., & Rogers R.G. (2020) Race/ethnicity, maternal educational attainment, and infant mortality in the United States. Biodemography Soc Biol., 66(1), 1-26. doi: 10.1080/19485565.2020.1793659

[5] Examining the Black US Mortality rate and how to cut it by Andis Robeznieks (2021)