Pre-eclampsia Self-Screening

Hypertensive Disorders

Hypertensive (high blood pressure) disorders of pregnancy are a major cause of poor pregnancy outcomes in both Canada and internationally. These disorders encompass pre-existing hypertensiongestational hypertension (develops during pregnancy) and preeclampsiaPreeclampsia develops when an individual has high blood pressure and involvement of other organ systems, such as liver dysfunction. This is risky for both the health of the pregnant person and baby.

Low-Dose Aspirin Therapy

A substantial amount of research suggests that low dose Aspirin (162 mg) taken by an at-risk pregnant person daily until 36 weeks of pregnancy is effective in reducing the risk of developing preeclampsia. Based on available evidence, low-dose aspirin therapy is not associated with any short- or long-term adverse outcomes. It is not beneficial for low-risk individuals. 

 Read this handout by the Association of Ontario Midwives on low dose ASA therapy. 

The Importance of Exercise

Research shows that 150 minutes of moderate intensity exercise each week reduces your risk of developing pre-eclampsia by 40%.   In other words, this level of exercise is as protective as daily ASA. Regular exercise also has other health benefits like improving mood and reducing the risk of developing gestational diabetes.  150 minutes can sound like a lot, but the weekly exercise goal can be spread over the entire week.  For example, a 30-minute walk, at a brisk pace, five days a week, reaches the goal.

Am I at risk?

If you have one of the following risk factors ASA is recommended:

  • Pre-eclampsia in a previous pregnancy
  • History of hypertensive disease in pregnancy and needed medication
  • Hypertension when you are not pregnant
  • Kidney Disease
  • Autoimmune disease (e.g., Systemic Lupus)
  • Antiphospholipid or anticardiolipin syndrome
  • Diabetes (non-pregnant)

If you have two or more of the following risk factors ASA is recommended:

  • First pregnancy or 10 year gap between previous pregnancy
  • Age 40 or older
  • Multiple pregnancy (i.e., twins)
  • Your sister or mother had pre-eclampsia
  • Your pre-pregnancy BMI is greater than 30

Lastly, if you decide to have genetic screening in the form of eFTS, we will also look at two specific markers: PAPP-A and PIGF.  If either of these marker are low, you are at higher risk for pre-eclampsia and ASA is recommended.

Your midwife will have you complete a self-screening tool prior to your first appointment. If low-dose aspirin therapy is indicated, she will discuss the appropriate plan of care for you based on your risk factors.