Read More
Pregnancy Risk Factors
You may also download a printable version of this table.
| Category Information Sources |
Risk Factors | Why this is relevant |
|
Anthropometrics:
|
Pre-pregnancy overweight | Goals for weight gain throughout pregnancy |
| Pre-pregnancy underweight | Goals for weight gain throughout pregnancy | |
| Inadequate rate of weight gain | Goals and recommendations for energy intake | |
| Excessive rate of weight gain | Goals and recommendations for energy intake | |
|
Biochemical
|
Anemia and/or iron deficiency | Need for supplemental iron |
| Other biochemical indicators outside normal range | Ongoing monitoring of specific medical conditions | |
|
Medical/Clinical – Current Pregnancy
|
Multiple fetuses | Increased nutrient needs, adjustment of weight gain goals |
| IUGR | Evaluation of weight gain | |
| Macrosomia | Evaluation of weight gain and/or for gestational diabetes | |
| Lactation during current pregnancy | Recommendations for nutrient intake, especially energy |
|
| Hyperemesis gravidarum | May indicate need for medical nutrition therapy | |
| Activity restriction for current pregnancy | Affects energy intake recommendations | |
| Hypertension, edema | May indicate need for medial therapy | |
| Nausea or vomiting | Can increase nutritional risk if significant effects on intake and/or weight gain | |
| Positive urine screen for glucosuria, ketonuria | Need for medical nutrition therapy | |
| Blood glucose screen at 24-28 weeks | Need for medical nutrition therapy | |
| Obvious signs of malnutrition | Need for medical nutrition therapy | |
|
Medical/Clinical – Previous pregnancies
|
History of pregnancy-induced hypertension (PIH), gestational diabetes, anemia, inadequate weight gain, infection, hemorrhage | Can be indicate increased risk for subsequent pregnancies |
| History of premature delivery, infant with low birthweight, or high birthweight (>4000 g or 8 lb, 12 oz) | May indicate previous nutritional problems and increased risk for current pregnancy | |
| Infant with birth defect, e.g., neural tube defect | May affect recommendation for folate intake | |
| Maternal weight changes in previous pregnancies outside recommended range | Potential indicator of risk for current pregnancy | |
| Parity and interconceptual period | May increase risk for iron deficiency and excessive maternal postpartum weight retention | |
|
Medical/Clinical – Maternal, current and history
|
Chronic diseases (e.g., diabetes, hypertension) |
Need to ensure specialty care May require medical nutrition therapy |
| Gastrointestinal disorders (e.g., malabsorption, lactose intolerance) |
Need to ensure specialty care May require medical nutrition therapy |
|
| Genetic metabolic disorder (e.g., phenylketonuria) | Refer for specialty care and medical nutrition therapy | |
| History of mental illness or depression | May affect nutrient intake and may indicate need for referral for specialty care | |
| Eating disorders (e.g., anorexia nervosa) | Refer for specialty care and medical nutrition therapy | |
| Oral health, dental issues |
May affect nutrient intake Periodontal disease associated with low birthweight, SGA |
|
| Recurrent infections or illness (e.g., foodborne illness, sexually transmitted diseases) |
May affect nutrient needs May have implications for pregnancy outcome |
|
| Observable injuries, old or new | May indicate domestic abuse and need for referral | |
| Present or past use of tobacco, alcohol, drugs |
May affect nutrient needs and intake Refer for treatment |
|
| Physical activity and exercise (recreation preferences, sedentary behavior) | May affect recommendations for energy intake | |
| Age <19 years | Affects recommendations for weight gain and nutrient intake | |
| HIV infection/AIDS |
Medical nutrition therapy to manage symptoms, medication-nutrient interactions Affects infant feeding choice |
|
| Bariatric surgery (gastric bypass) |
May affect recommendations for specific nutrients (iron, vitamin B12, folate, calcium) Affects amounts and types of foods consumed |
|
|
Drug-nutrient interaction
|
Use of medication (prescription or over-the-counter) |
Nutrient interactions Appropriateness during pregnancy |
| Substance Abuse |
Increased risk to fetus Refer |
|
| Use of tobacco | Associated with fetal growth retardation and low brithweight, other complications | |
| Inappropriate use of vitamins, minerals, herbs |
Potential drug-nutrient interactions Consideration of safety during pregnancy |
|
|
Dietary intake
|
Inappropriate nutrient intake (energy, protein, vitamins, minerals, fluid) | Recommendations for nutrient intake, supplements |
| Inappropriate food pattern (frequency of meals and snacks) | May affect nutrient intake | |
| Nausea, vomiting, constipation, taste and appetite changes, reflux or “heartburn” | May affect food choices and interfere with adequate intake | |
| Food insecurity and/or inadequate food supply |
Affects food choices, nutrient intake Refer (housing, food, transportation) |
|
| Vegetarianism | May increase risk for some specific nutrient deficiencies (e.g., iron, zinc, calcium, vitamin D, riboflavin, vitamin B12, iodine) | |
| Lactose intolerance | Affects food choices, nutrient intake | |
| Limited support system |
May affect food choices and availability Refer if post-partum depression is suspected Refer to behavioral health specialist |
|
| Domestic abuse | Refer | |
| Psychological stresses; disinterest in healthy eating practices |
May affect food choices and availability Refer if post-partum depression is suspected Affects development of nutrition interventions |
|
| Negative feelings about pregnancy and parenting |
Refer (risk for post-partum depression) Refer to behavioral health specialist |
|
| Beliefs/practices related to food and eating (cultural, regional, etc.) | Can affect food choices, nutrient intake |
|
| Low level of mastery or self-esteem | Can be associated with a low rate of weight gain | |
| Pica |
Can interfere with iron absorption, alter energy intake Potential for intestinal obstruction, toxicity |
Copyright 2007 | Disclaimers
Last updated: 08/30/2007