High Blood Pressure During Pregnancy Fact Sheet

When high blood pressure (HBP) occurs during pregnancy and is not appropriately treated, it may negatively affect the health of both a mother and her baby during pregnancy, during delivery, or after delivery.1,2 High blood pressure, also known as hypertension (HTN), is a common and treatable health condition that occurs in 6% to 8% of all pregnancies among women ages 20 to 44 years in the United States.3,4 Complications from high blood pressure in pregnancy have become more common over the years, increasing from 5.3%* of delivery hospitalizations in 1993 to 9.1%* of delivery hospitalizations in 2014.5

For the mother, any hypertensive conditions, regardless of whether they were first diagnosed before (chronic HTN) or during (gestational HTN) pregnancy, may be linked to preeclampsiaExternal, eclampsiaExternal, stroke, pregnancy induction (speeding up the pregnancy to give birth), and placental abruption (the placenta separating from the wall of the uterus).1,6,7

For the baby, high blood pressure during pregnancy may affect the mother’s blood vessels—including the ones in the umbilical cord. When the blood vessels tighten, it becomes more difficult for the baby to get enough oxygen and nutrients to grow, and may result in preterm delivery (birth that occurs before 37 weeks of pregnancy) and low birth weight (when a baby is born weighing less than 5 pounds, 8 ounces).1,8

The good news is that this is a preventable issue. Poor outcomes may be detected early and/or avoided by increasing awareness, improving patient education and counseling, and providing appropriate treatment of any high blood pressure conditions before, during, or after pregnancy.1

*The percentages were calculated from a rate of 528.9 and 912.4 per 10,000 delivery hospitalizations.

What Should Women With High Blood Pressure Do Before, During, and After Pregnancy?

Before Pregnancy

  • Make a plan for pregnancy and talk with a health care provider about the following:
    • Review medical conditions and current medicines. Women planning to become pregnant should discuss the need for any medicine before becoming pregnant and should make sure that they are taking only medicines that are necessary.15
    • Find ways to reach and maintain a healthy weight through healthy eating and regular physical activity.1,15
A doctor measuring a pregnant woman's blood pressure.

During Pregnancy

  • Engage early in regular prenatal careExternal and attend scheduled health care provider appointments.
  • Discuss current medicines and which medicines are considered to be safe with a health care provider. Pregnant women should not stop or start taking any type of medicine that they need, including over-the-counter medicines, without first talking with a health care provider.15
  • Keep track of blood pressure routinely by using a home blood pressure monitor Cdc-pdf[PDF-1.1M].External Contact a health care provider if blood pressure becomes higher than usual or if you experience any other signs and symptoms of preeclampsia (e.g., headache, dizziness, blurry vision).
  • Continue to maintain a healthy lifestyle24 and track weight during pregnancy.

After Pregnancy

Types of High Blood Pressure Conditions Before, During, and After Pregnancy

High blood pressure can appear as many different conditions at various times before or during pregnancy. Your health care provider (doctor or nurse) should look for these conditions before and during pregnancy:5,1

Preeclampsia/Eclampsia

In middle, late, or after pregnancy

Preeclampsia is defined as the new onset of high blood pressure (more than or equal to 140/90 mmHg)* on two occasions, at least 4 hours apart, or blood pressure readings of more than or equal to 160/110 mmHg in a woman with previously normal blood pressure. Learn about measuring blood pressure.

Risk factors for preeclampsia include:1

  • Primiparity (giving birth for the first time)
  • Preeclampsia during a previous pregnancy
  • Chronic hypertension, chronic renal (kidney) disease, or both
  • A history of thrombophilia (an abnormal condition that increases risk of blood clots in blood vessels)
  • Multiple babies in one pregnancy (e.g., twins, triplets)
  • In vitro fertilization
  • A family history of preeclampsia
  • Type I or type II diabetes
  • Obesity
  • Lupus (an autoimmune disease)
  • Advanced maternal age (older than 40 years)

Preeclampsia is accompanied by protein in the urine (proteinuria) and possibly other organ problems. These problems could include:

  • Low blood platelet count
  • Abnormal kidney or liver function, resulting in sudden weight gain, swelling of face or hands, or upper abdominal pain
  • Fluid in the lungs, causing difficulty breathing
  • Changes in vision, including seeing spots or changes in eyesight
  • Severe headache, nausea, or vomiting

Preeclampsia is typically diagnosed after 20 weeks of pregnancy and most often closer to delivery. It can occur together with another high blood pressure condition (e.g., chronic hypertension with superimposed preeclampsia). Preeclampsia affects 4% of pregnancies in the United States.1,10

On rare occasions, preeclampsia can occur after childbirth. This is a serious medical condition known as postpartum preeclampsia. It may develop in women without any history of preeclampsia.21 The symptoms for postpartum preeclampsia are similar to the symptoms and signs of preeclampsia, and it is typically diagnosed within 48 hours after delivery but can occur up to 6 weeks later.18

When preeclampsia is associated with seizures (without the mother having epilepsy), it is known as eclampsia.1,5

Chronic Hypertension

Before or in early pregnancy

In this condition, a woman develops high blood pressure (more than or equal to 140/90 mmHg)* before conception or before 20 weeks of pregnancy.1

Chronic Hypertension With Superimposed Preeclampsia

In early, middle, or late pregnancy

This condition happens when there are elevated blood pressure readings of less than 160/110 mmHg in pregnant women who develop protein in their urine after 20 weeks of pregnancy or before 20 weeks of pregnancy with protein in urine and accompanying organ problems.1

Gestational Hypertension

In middle or late pregnancy

This condition happens when high blood pressure (more than or equal to 140/90 mmHg)* happens only during pregnancy, without the presence of protein in the urine. It is typically diagnosed after 20 weeks of pregnancy or close to delivery. Gestational hypertension usually goes away after childbirth; however, affected women have an increased risk of developing chronic hypertension in the future.1,22

*In November 2017, the American College of Cardiology (ACC) and the American Heart Association (AHA) updated the definition of chronic hypertension to be more than or equal to 130/80 mmHg instead of more than or equal to 140/90 mmHg.23 This update may increase the number of women with high blood pressure conditions during or before pregnancy who will need additional attention from their health care providers.

More Information

For more information about high blood pressure during pregnancy, see the following resources:

  1. American College of Obstetricians and Gynecologists, Task Force on Hypertension in Pregnancy. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. Obstet Gynecol 2013;122(5):1122–31.
  2. Hutcheon JA, Lisonkova S, Joseph KS. Epidemiology of pre-eclampsia and the other hypertensive disorders of pregnancy. Best Pract Res Clin Obstet Gynaecol 2011;25(4):391–403.
  3. National Heart, Lung, and Blood Institute. High blood pressure in pregnancy. [cited 20 Oct 2017].
  4. Bateman BT, Shaw KM, Kuklina EV, Callaghan WM, Seely EW, Hernandez-Diaz S. Hypertension in women of reproductive age in the United States: NHANES 1999-2008. PLOS ONE 2012;7(4):e36171.
  5. Centers for Disease Control and Prevention. Data on selected pregnancy complications in the United States. [cited 20 Oct 2017]. Available from URL: https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pregnancy-complications-data.htm.
  6. Callaghan WM, Creanga AA, Kuklina EV. Severe maternal morbidity among delivery and postpartum hospitalizations in the United States. Obstet Gynecol 2012;120(5):1029–36.
  7. Creanga AA, Berg CJ, Ko JY, Farr SL, Tong VT, Bruce FC, et al. Maternal mortality and morbidity in the United States: where are we now? J Womens Health (Larchmt) 2014;23(1):3–9.
  8. Macdonald-Wallis C, Tilling K, Fraser A, Nelson SM, Lawlor DA. Associations of blood pressure change in pregnancy with fetal growth and gestational age at delivery: findings from a prospective cohort. Hypertension 2014;64(1):36–44.
  9. Seely EW, Ecker J. Chronic hypertension in pregnancy. Circulation 2014;129(11):1254–61.
  10. U.S. Preventive Services Task Force. Screening for preeclampsia: U.S. Preventive Services Task Force recommendation statement. JAMA 2017;317(16):1661–67.
  11. Centers for Disease Control and Prevention. High blood pressure risk factors. [cited 20 Oct 2017]. Available from URL: https://www.cdc.gov/bloodpressure/risk_factors.htm.
  12. Ros HS, Cnattingius S, Lipworth L. Comparison of risk factors for preeclampsia and gestational hypertension in a population-based cohort study. Am J Epidemiol 1998;147(11):1062–70.
  13. Thombre MK, Talge NM, Holzman C. Association between pre-pregnancy depression/anxiety symptoms and hypertensive disorders of pregnancy. J Womens Health (Larchmt) 2015;24(3):228–36.
  14. Tanaka M, Jaamaa G, Kaiser M, Hills E, Soim A, Zhu M, et al. Racial disparity in hypertensive disorders of pregnancy in New York state: a 10-year longitudinal population-based study. Am J Pub Health 2007;97(1):163–70.
  15. Centers for Disease Control and Prevention. Treating for two: medications and pregnancy. [cited 20 Oct 2017]. Available from URL: https://www.cdc.gov/pregnancy/meds/treatingfortwo/index.html.
  16. Abi-Said D, Annegers JF, Combs-Cantrell D, Frankowski RF, Willmore LJ. Case-control study of the risk factors for eclampsia. Am J Epidemiol 1995;142(4):437–41.
  17. Centers for Disease Control and Prevention. Show Your love: steps to a healthier me and baby-to-be. [cited 20 Oct 2017]. Available from URL: https://www.cdc.gov/preconception/showyourlove/documents/Healthier_Baby_Me_Plan.pdf Cdc-pdf[PDF-2 MB].
  18. Mayo Clinic. Postpartum preeclampsia. [cited 20 Oct 2017]. Available from URL: https://www.mayoclinic.org/diseases-conditions/postpartum-preeclampsia/symptoms-causes/syc-20376646External.
  19. Matthys LA, Coppage KH, Lambers DS, Barton JR, Sibai BM. Delayed postpartum preeclampsia: an experience of 151 cases. Am J Obstet Gynecol 2004;190(5):1464–6.
  20. Larsen WI, Strong JE, Farley JH. Risk factors for late postpartum preeclampsia. J Reprod Health Med 2012;57(1–2):35–8.
  21. Bigelow CA, Pereira GA, Warmsley A, Cohen J, Getrajdman C, Moshier E, et al. Risk factors for new-onset late postpartum preeclampsia in women without a history of preeclampsia. Am J Obstet Gynecol 2014;210(4):338:e1–8.
  22. American College of Obstetricans and Gynecologists. Preeclampsia and high blood pressure during pregancy. [cited 28 Nov 2017]. Available from URL: https://www.acog.org/Patients/FAQs/Preeclampsia-and-High-Blood-Pressure-During-Pregnancy#gestationalExternal.
  23. Whelton PK, Carey RM, Aronow WS, Casey DE Jr., Collins KJ, Dennison Himmelfarb C, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension 2017:e13–e144.
  24. Liu Y, Croft JB, Wheaton AG, Kanny D, Cunningham TJ, Lu H, et al. Clustering of five health-related behaviors for chronic disease prevention among adults, United States, 2013. Prev Chronic Dis 2016;13:160054. Available from URL: https://www.cdc.gov/pcd/issues/2016/16_0054.htm.