Increasing maternal age, pre-existing conditions, and lifestyle factors contribute to a surge in high-risk pregnancy cases.
Climbing the Mountain of High-Risk Pregnancies
When Ms. Germaine Heng faced her third pregnancy in 2021, she likened the experience to scaling treacherous mountains. Struggling with gestational diabetes and pre-eclampsia—a severe blood pressure condition—Ms. Heng endured hospitalizations and emergency interventions to ensure her baby’s survival.
Her case reflects a growing trend in Singapore, where public hospitals are seeing a steady increase in high-risk pregnancies. Factors such as advanced maternal age, obesity, and pre-existing conditions are contributing to the rise.
Understanding High-Risk Pregnancies
A high-risk pregnancy is one where complications are more likely to affect the health of the mother, baby, or both. Women with pre-existing illnesses, a history of pregnancy complications, or those carrying multiples often require specialized care.
Public hospitals like KK Women’s and Children’s Hospital (KKH), National University Hospital (NUH), and Singapore General Hospital (SGH) report significant increases in high-risk pregnancy clinic visits. For instance, KKH’s attendance rates jumped from 1,966 visits in 2020 to 3,915 in 2022, with 1,898 visits recorded in the first half of 2023 alone.
Why Are High-Risk Cases Increasing?
Experts attribute the rise to several factors:
Advanced Maternal Age: The median maternal age in Singapore was 31 in 2021, up from 30.5 in 2015. Conceptions among women in their 40s have doubled over three decades.
Obesity Rates: Obesity among women aged 18-74 increased from 7.8% in 2013 to 10.2% in 2022, raising the risk of gestational diabetes and other complications.
Fertility Treatments: Assisted reproductive techniques, such as in-vitro fertilization, often result in multiple pregnancies, which are inherently riskier.
Improved Medical Management: Advances in healthcare enable women with severe conditions like organ transplants or chronic illnesses to conceive safely, though such pregnancies require multidisciplinary care.
Managing High-Risk Pregnancies
Specialized centers, such as KKH’s Obstetric High Risk Clinic (OHRC) and SGH’s Centre for High-Risk Pregnancies (Chirp), offer comprehensive care. Multidisciplinary teams—including obstetricians, endocrinologists, dietitians, and anesthetists—work together to manage complex cases.
Preventive measures are also emphasized. Women with chronic conditions are advised to undergo pre-conception counseling, optimize their health, and review medications to ensure safety during pregnancy.
Mental Health Challenges
High-risk pregnancies often take a toll on mental health. Depression and anxiety are prevalent, affecting 10-20% of pregnant women. Addressing these issues is essential for overall maternal well-being.
A Journey of Resilience
For Ms. Heng, the challenges of her high-risk pregnancy were daunting but ultimately rewarding. After weeks of neonatal care, her daughter was discharged healthy, marking the end of a difficult yet transformative journey.
As Singapore’s hospitals adapt to the rising demands of high-risk pregnancies, they continue to offer hope and care for mothers navigating these arduous paths.
