6 Routine Tests During Pregnancy That Are Important for Baby (and Mom’s Heart Health)

When: Every visit

Why It’s Important During Pregnancy: Checking your blood pressure is an easy, routine part of every prenatal visit. It’s also a key health factor and is important to track. Your health care professional will use a blood pressure cuff to check your blood pressure and track two numbers. Blood pressure is measured in millimeters of mercury, or mmHg.

• Systolic pressure. This is the top or upper number. It measures how much pressure your blood is pushing against your artery walls when the heart beats.
• Diastolic pressure. This is the bottom or lower number. It shows how much pressure your blood is pushing against your artery walls while the heart rests between beats

When you are pregnant, a non-hypertensive reading is less than 140/90 mmHg. If your blood pressure is 140 or higher OR 90 or higher and you have any of these symptoms, call 911: severe headache, change in vision, abdominal pain, chest pain, significant swelling, or shortness of breath. Even if you don’t have those symptoms, and your blood pressure is 160 or higher OR 110 or higher, call your health care team immediately.

High blood pressure, also called hypertension, is when your blood pressure is consistently too high. Untreated high blood pressure can damage your circulatory system. This can lead to heart attack, stroke and other health threats.

Rates of high blood pressure before and after pregnancy have increased in recent years. Every woman should check their blood pressure during pregnancy and in the months after birth.

Why It’s Important for Mom: High blood pressure is dangerous for mom. It can lead to maternal death and increased risk for heart disease later in life. High blood pressure during pregnancy is linked with a 67% higher risk of later heart disease. Preeclampsia, which is new onset high blood pressure that usually develops after 20 weeks of pregnancy with protein in urine or other signs of organ damage, increases the risk of dying from heart disease by 75%.

What to Discuss With Your Health Care Team:

• Your reading each visit and whether it’s within a non-hypertensive range
• If you or family members have a history of high blood pressure, preeclampsia or eclampsia
• Whether you should monitor your blood pressure at home
  • If so, how often?
  • What should you do with the results?
  • You can download the At-home blood pressure sheet (PDF) to log your home readings
• What to do if a reading is high
• If you should consider taking a low-dose aspirin during pregnancy to prevent preeclampsia

When: Every visit

Why It’s Important During Pregnancy: Your health care team will weigh you and record your weight at each visit. It’s normal to gain weight during pregnancy. Your team can help you understand what a healthy weight is for you.

Why It’s Important for Mom:: Weight is a key risk factor for maternal death and developing heart disease before, during and after pregnancy. Research has shown that women who enter pregnancy overweight or obese are at a greater risk for high blood pressure, preeclampsia, gestational diabetes, pre-term childbirth and delivering a baby who is small for it’s gestational age.

What to Discuss With Your Health Care Team:

• How much weight you should gain during pregnancy
• How many more calories per day you should consume during pregnancy
• What types of foods you should eat
• Healthy ways to manage your weight during pregnancy and after delivery

When: Between 24 and 28 weeks. If you have a history of gestational diabetes or other risk factors, your health care team might also test your blood glucose early in pregnancy.

Why It’s Important During Pregnancy: A blood glucose screening measures the level of sugar, or glucose, in your blood in a set time. In one type of blood glucose screening, you’ll drink a sugary liquid, then have your blood drawn one hour later to test the amount of sugar in your blood. A three-hour version of the test may be needed based on your results from the first test.

Your body naturally produces insulin, a hormone that controls blood sugar. Pregnancy can interfere with the process, causing blood sugar levels to increase and passing excess sugar to the fetus.

Diabetes, which increases the risk of heart problems, occurs when blood glucose is too high. The main kinds of diabetes are:

• Type 1 diabetes is also called insulin-dependent diabetes. People with Type 1 diabetes must take insulin or other medications daily. This makes up for the insulin not produced by the body.

• Type 2 diabetes the most common form, arises due to insulin resistance. The body can’t efficiently use the insulin it makes, and the pancreas gradually loses its ability to make insulin.

• Gestational diabetes develops during pregnancy. It affects about 6 in 100 pregnancies and can affect the health of both a woman and her child short- and long-term.

Why It’s Important for Mom: The risk of heart problems increases with all types of diabetes. Untreated gestational diabetes can lead to early delivery and increase the risk of high blood pressure during pregnancy. While gestational diabetes usually goes away after delivery, women who have had it face a 68% higher risk of developing heart disease later.

What to Discuss With Your Health Care Team:

• When you should be aware of developing gestational diabetes
• Symptoms or risk factors to be aware of
• How to manage gestational diabetes while pregnant (such as with lifestyle changes or taking insulin)
• How to reduce your risk for developing diabetes after delivery
• How gestational diabetes impacts your long-term risk for diabetes and heart disease
• How to track your home blood glucose readings (Download the At-Home Blood Glucose Log (PDF))

When: Early and throughout pregnancy

Why It’s Important During Pregnancy: A complete blood count (sometimes called a panel) can help screen for many conditions. The blood draw usually takes less than a minute. Blood will be drawn, usually from the inner elbow. It can be used to assess general health, diagnose certain medical conditions and monitor existing conditions and treatments.

Why It’s Important for Mom: Results can help your health care team understand important aspects of your health during pregnancy, including anemia and blood-clotting disorders.

Anemia (low hemoglobin) is when the body lacks enough healthy red blood cells to carry enough oxygen to its tissues. The condition can cause pregnancy complications and lead to multiple heart problems, including heart failure and arrythmia. You can help reduce the risk of anemia with:

• Prenatal vitamins with iron and folic acid
• A healthy diet rich in iron, folate, vitamin B-12 and vitamin C

A blood-clotting disorder can be especially dangerous during pregnancy, when more blood pumps through your body, adding pressure on your blood vessels. Blood clots can lead to problems such as stroke, heart attack, miscarriage, stillbirth and preeclampsia.

What to Discuss With Your Health Care Team:

• Your blood test results (and whether everything falls within normal ranges)

When: A urinalysis should be performed both early and later in pregnancy. Some health care professionals might test at every visit.

Why It’s Important During Pregnancy: At your first visit, a urine test can confirm your pregnancy. Doing this test throughout pregnancy can check for conditions such as urinary tract disease, urinary tract infection (UTI) and high levels of glucose or protein.

Why It’s Important for Mom: A urinalysis can help assess your health and identify signs of more serious conditions. High levels of glucose can indicate gestational diabetes. High levels of protein can indicate preeclampsia when coupled with high blood pressure. Additional testing may be needed.

What to Discuss With Your Health Care Team:

• Ask for your results during each visit and whether they are within normal ranges.

Edinburgh Postnatal Depression Scale (EPDS)

When: Postpartum. You may be screened at visits with your health care team and at your child’s pediatrician visits. But women should discuss any concerns about depression or anxiety with their health care team anytime — before, during or after delivery. You do not have to wait for a postpartum screening to address any questions.

Why It’s Important During and After Pregnancy: If you’re having prolonged or abnormal feelings of sadness or anxiety, or are concerned about your behavior, talk to your health care team. It's OK to ask. Don't just try to "power through” or "shake it off.”

Why It’s Important for Mom: Women can expect changes in hormones and emotions throughout pregnancy and the postpartum period. The “baby blues,” a temporary form of depression, anxiety or other upset feelings, are common for many women after delivery. It typically goes away after about two weeks.

Some women will have more intense, lasting or disabling conditions such as postpartum depression, postpartum anxiety or postpartum psychosis. Addressing and managing these conditions is important for both your short- and long-term health. Depression and anxiety are linked with heart disease more often and at younger ages in women than in men.

What to Discuss With Your Health Care Team:

• Any concerns or troubling feelings
• Any past depression, anxiety or family history of those conditions