High-risk pregnancies are rising: What expecting mothers should know

As more women conceive later and with pre-existing health conditions, doctors stress that awareness, early diagnosis and regular care are key to safer pregnancies

High-risk pregnancies are no longer exceptions and are fast becoming the norm, particularly among urban Indian women. Doctors say changing lifestyles, delayed motherhood and a growing burden of lifestyle diseases are reshaping how pregnancies are classified and managed. While the term “high-risk” can sound alarming, experts stress that early identification and timely care can make a decisive difference to outcomes for both mother and baby.

 

Why are high-risk pregnancies increasing in cities?

 

Doctors say the rise in high-risk pregnancies reflects broader social and demographic changes rather than isolated medical issues. Urban life has become increasingly sedentary, with long working hours, limited daily movement and high stress levels now part of routine life for many women. This combination often affects overall fitness and metabolic health even before conception.

 

 

Another defining shift is delayed motherhood. Many women are choosing to conceive in their mid-to-late 30s or early 40s, often after establishing careers or achieving financial stability. While this is a personal and valid choice, advancing maternal age naturally increases pregnancy-related risks and the likelihood of underlying health conditions.

 

According to Dr Nidhi Sharma Chauhan, Obstetrician and Gynaecologist at Saifee Hospital, “Pregnancies at an older age are more likely to be accompanied by diabetes, high blood pressure or thyroid disorders, all of which require closer monitoring.”

 

She also points to the growing use of assisted reproductive technologies (ART), including IVF, as a contributing factor. Such pregnancies, while successful for many couples, statistically carry higher chances of complications and therefore fall more often into the high-risk category.

 

Health conditions and habits that increase pregnancy risk

 

Beyond age and environment, many women enter pregnancy with medical or lifestyle-related risk factors that immediately classify it as high-risk. Excess body weight is one of the most common concerns, as it raises the chances of gestational diabetes, pregnancy-induced hypertension and delivery complications.

 

Conditions such as polycystic ovary syndrome (PCOS), impaired glucose tolerance, diabetes, thyroid disorders and chronic high blood pressure are increasingly seen in women of reproductive age. These conditions can affect placental function, foetal growth and maternal well-being if not managed carefully.

 

Lifestyle choices also matter. Smoking and vaping are known to adversely affect pregnancy outcomes. ART-related pregnancies may involve hormonal stimulation, multiple foetuses or larger babies, each of which independently increases medical risk.

 

Together, these factors mean that many pregnancies are classified as high-risk not because of complications later on, but because of the mother’s baseline health at the time of conception.

 

High-risk pregnancies can be identified early

 

Many people assume complications only appear later in pregnancy, but doctors say risk can be identified surprisingly early.

 

“A pregnancy can be flagged as high-risk as early as the first prenatal visit, usually between six and ten weeks,” says Dr Sonia Golani, Consultant Gynaecologist and Obstetrician at Bhailal Amin General Hospital, Vadodara.

 

Risk assessment is based on a combination of factors, including

• Maternal age
• Existing medical conditions
• Past pregnancy history
• Lifestyle habits
• Multiple pregnancies
• Any infections or medication exposure in early pregnancy

 

Early scans and tests that flag hidden risks

 

The first trimester, up to 13 weeks, is a crucial window for identifying potential problems. Early screening allows doctors to intervene before complications escalate.

 

Key tests during this phase include:

 

• Early ultrasound scans (around 6–8 weeks)
• First-trimester blood tests
• Combined screening between 11–13 weeks
• Early screening for diabetes and blood pressure
• Genetic screening, where indicated

 

“These tests help us identify risks early and plan care accordingly,” Dr Golani explains.

 

Possible complications if risks are missed

 

If a high-risk pregnancy is not recognised early, complications can affect both mother and baby.

 

For mothers, these may include

• Severe pregnancy-related hypertension with organ involvement
• Gestational diabetes
• Anaemia
• Preterm labour
• Placental problems

 

Babies may face

• Growth restriction
• Premature birth
• Low birth weight
• Congenital anomalies
• In severe unmanaged cases, stillbirth

 

How early care improves outcomes

 

Early and regular prenatal care can dramatically reduce these risks. Once a pregnancy is identified as high-risk, doctors can tailor monitoring schedules, start medications and lifestyle changes on time, optimise nutrition and supplements, and identify warning signs before they become emergencies.

 

“High-risk does not mean high-failure,” Dr Golani emphasises. “With personalised care and close monitoring, most women go on to have safe deliveries and healthy babies.”

 

What expecting mothers should take away

 

Experts agree that awareness is the first step. Planning pregnancy with optimal health, attending early antenatal visits and following medical advice closely can significantly improve outcomes.

 

As high-risk pregnancies become more common, informed and proactive care is emerging as the strongest safeguard for mothers and their babies.   

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This report is for informational purposes only and is not a substitute for professional medical advice.