Who is at risk for preeclampsia?

Any pregnant person can develop preeclampsia, but some people are at a higher risk than others. Risk factors include first pregnancies (excluding miscarriages and abortions), being pregnant with multiples (e.g., twins), obesity, previous and/or family history of preeclampsia, age under twenty, gestational diabetes, and certain health conditions prior to pregnancy (e.g., chronic hypertension, kidney disease, lupus, or diabetes).

There is also an association between cardiovascular disease and preeclampsia, such that people who had high blood pressure during pregnancy have nearly double the rate of incident cardiovascular disease and a five times higher rate of hypertension when compared to people without high blood pressure during pregnancy.^[1] However, it is difficult to determine the direction of this relationship. It could be that preeclampsia causes remodeling of the heart that increases the risk of later cardiovascular disease, or it could be that people who develop high blood pressure during pregnancy are already at an increased risk for later cardiovascular disease. In fact, people with preeclampsia may have other cardiovascular risk factors present, such as obesity,^[2] metabolic abnormalities, dyslipidemia, insulin resistance,^[3] elevated inflammatory responses, propensity for blood clotting, and endothelial dysfunction.^[4][5]