Pregnancy-related conditions

Preterm labour is when you start having regular contractions and your cervix starts to open after 20 weeks but before 37 weeks of pregnancy.

There are several possible risk factors for preterm labour, including:

• Infection: particularly a urinary tract or intra-amniotic infection
• High blood pressure, diabetes, or previous preterm births
• Multiple pregnancies (twins or more)
• Premature rupture of membranes, placenta previa, or placental abruption.
• Lifestyle and environmental factors. This could include smoking, substance use, high stress levels, or inadequate prenatal care. 

A baby who is born too early can have health issues. These may include low birth weight, trouble breathing, organs that are not fully formed, and trouble seeing or hearing. Preterm babies will often spend time in a neonatal intensive care unit before going home.

Fetal anomalies are also known as birth defects, congenital anomalies, and congenital disorders. They are a problem with the shape of a body part or with how a body part works that happen as your baby is growing in your womb. The anomaly may affect one or more parts of your baby’s body. The anomaly may be found during your pregnancy, after your baby is born, or during their first year of life.

Fetal anomalies are a major cause of infant and childhood death, chronic illness, and disability. The effect the fetal anomaly has on your child’s health depends on the severity of the anomaly and the organs affected. 

In most cases, the exact cause of the fetal anomaly is unknown. Some factors that may lead to a fetal anomaly are listed below.

• Genetics: Your genes may play a major role in the development of a fetal anomaly. Sometimes, your baby inherits a genetic trait from you or the baby’s other biological parent. In other cases, a gene can change as the baby is developing. This is known as a gene mutation.
• Your age: If you are at an advanced maternal age when you get pregnant, your baby may be at greater risk of certain conditions. Your doctor will discuss these with you.  
• Chemicals: Exposure to certain chemicals, medications, alcohol, or tobacco during your pregnancy may increase the risk of a fetal anomaly.
• Infection: Contracting certain infections (e.g. syphilis or rubella) while you are pregnant can affect your baby’s development and may also lead to congenital anomalies.
• Nutrition: What you eat or don’t eat may affect your baby’s growth and development. For example, if you don’t get enough folate (a vitamin found in fruits, vegetables, and beans), your baby’s risk of a neural tube defect may increase. Read more about Health Canada's foods to avoid during pregnancy.

Diagnosis & testing

Fetal anomalies are typically detected through prenatal screening and diagnostic tests. Examples include: 

• Ultrasound: This test uses sound waves to look at how the baby’s body is developing.
• Maternal Serum Screening: Measures specific markers in the pregnant person’s blood to assess the risk of chromosomal abnormalities.
• Non-Invasive Prenatal Testing (NIPT): A blood test that screens for certain genetic conditions.
• Amniocentesis & Chorionic Villus Sampling (CVS): These tests involve taking a sample of the fluid or tissue that surrounds the baby in the womb. They can definitively diagnose certain conditions.
• Fetal MRI & Echocardiography: These tests can assess defects in the brain, spine and  heart.

Gestational diabetes develops when your blood sugar levels get too high during pregnancy. This can happen due to hormonal changes in your body that interfere with insulin function. Gestational diabetes typically develops in the second or third trimester of pregnancy. It usually goes away after your baby is born.

You are a higher risk of gestational diabetes if you have:

• A pre-pregnancy body mass index (BMI) greater than 30 kg/m2
• A family history of diabetes
• Advanced maternal age
• Polycystic ovary syndrome (PCOS). 

If not diagnosed and managed, gestational diabetes can lead to an increased risk of complications for you and your baby. This can include hypertensive disorders of pregnancy, a high birth weight for your baby, preterm birth and operative delivery. It can also increase your risk of developing type 2 diabetes and cardiovascular disease later in life.

Pregnancy-related hypertension is when you have high blood pressure during pregnancy.  The exact cause of high blood pressure in pregnancy is not fully understood. You are more likely to develop high blood pressure in pregnancy if you:

• Had chronic high blood pressure or chronic kidney disease before pregnancy
• Have certain health conditions, such as diabetes or lupus
• Had high blood pressure or preeclampsia in a previous pregnancy
• Have a pre-pregnancy body mass index (BMI) greater than 30 kg/m2
• Are under age 20 or over age 40
• Are pregnant with more than one baby
• Have a family history of high blood pressure in pregnancy

High blood pressure during pregnancy poses risks for both you and your baby. It can increase your risk of complications such as developing preeclampsia, eclampsia (seizures) or having a stroke. It can also increase your baby’s risk of low birth weight or the risk of preterm birth. It is also associated with an increased risk of cardiovascular disease later in your life.

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