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Risky business

What it means to be faced with a high-risk pregnancy.

Article Author: Tina Smithers Peckham

Article Date:

Doctor with pregnant patient

Pregnancy can be stressful in and of itself — from ensuring a smooth labor and delivery to getting baby’s nursery just right (bibs and bassinets and burp cloths… oh, my!). And then tack on the term “high-risk pregnancy,” and your stress level is liable to skyrocket. Fret not, Mama. Keep your anxiety at bay with the most up-to-date information… and the right care for you and your baby.

For starters, the factors that determine whether or not a pregnancy is considered "high risk" are plenty. According to maternal-fetal medicine specialist Kathryn Villano, MD, chief of Perinatal Services at Baptist Health and Wolfson Children’s Hospital, the most common reasons for a high-risk pregnancy are maternal.

“A mom may have underlying medical conditions, such as high blood pressure or diabetes, that increase her risk of complications in pregnancy,” Dr. Villano said. “She may already have a history of complicated pregnancies — frequent miscarriages, preterm delivery, pre-eclampsia, or pregnancy losses in the past.”

Other factors may have to do with the baby, which could include specific birth defects, genetic conditions, or a multiple pregnancy.

But no matter the cause, a maternal-fetal medicine physician, also known as “a high-risk OB,” like Dr. Villano is there to work alongside your trusted OB/GYN to help ensure that both Mom and baby stay as healthy as possible throughout the pregnancy. This additional support can be crucial in getting the best possible outcome for you and your baby.

The age conundrum

Some women might be all-too-familiar with the phrase "advanced maternal age” — a term given to expectant mamas over the age of 35 — though Dr. Villano jokingly likes to call it "The Well-Prepared Mom's Club."

"Most of my mamas over 35 are having a planned and much-desired pregnancy — often after finishing their education, achieving personal goals, establishing a career, and then deciding to grow their family," she said.

So, why does age play such a part when it comes to high-risk pregnancies? Simply put, women over 35 years old have a greater chance of conceiving a pregnancy affected by an abnormal or extra chromosome, which could raise the risk of certain birth defects.

Luckily, screenings and special ultrasounds can be done early in the pregnancy to help diagnose these medical conditions and prepare parents-to-be for any special care or arrangements their baby may need. Another age-related factor includes issues surrounding placenta function.

“The placenta is an organ that allows Mom's uterine blood vessels to grow and meet baby's blood vessels, helping oxygen and nutrition pass from Mom to baby,” Dr. Villano explained. “Moms over 40 years of age have a higher risk of placenta function problems because their blood vessels sometimes don't grow and change as readily. This can cause babies to be smaller at birth.

“Placenta function changes can also trigger high blood pressure complications in pregnancy such as pre-eclampsia,” she added. “We monitor routinely for these complications and can help prevent them in the first place.”

Don’t panic

The key to remember is that if your OB/GYN does suggest you see a high-risk specialist, don't let it be a major cause for concern. Yes, you can still have a healthy pregnancy if you’re considered high-risk.

"Maternal-fetal medicine specialists take care of all kinds of pregnancy complications and complex conditions. Sometimes, you may only pay one or two visits to our office for counseling, screening tests or a specialized ultrasound, and some pregnancies will need to be monitored more carefully,” Dr. Villano said. "But we provide lots of reassurance, too! More often than not, we are giving families good news."


When you’re expecting, it’s important to find the right provider for your needs, especially if you are experiencing a high-risk pregnancy. Seeking expert care throughout your pregnancy? Call 904.202.4HER (4437) to find an OB/GYN who delivers at a Baptist Health facility. To learn more about Baptist Health's labor and delivery, high-risk obstetrics, newborn and neonatal intensive care services, visit baptistjax.com/baby.

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