birthweight

Birth weight is the first weight of your baby, taken just after being born. A low birth weight means that the baby is less than 5 pounds, 8 ounces. A high birth weight means that the baby is more than 8 pounds, 13 ounces.

A baby with a low birth weight can be born too small, too early (premature), or both. This can happen for many different reasons. They include:

• Health problems in the pregnant parent
• Taking certain medicines during pregnancy
• Substance use during pregnancy
• Infections during pregnancy
• Being pregnant with multiple babies
• Problems with the placenta, the organ that brings oxygen and nutrients to the baby
• Having small parents
• Genetic conditions in the baby
• Birth defects

Babies with low birth weight may be more at risk of certain health problems. They include immediate problems, such as:

• Breathing problems
• Infections
• Hypoglycemia (low blood sugar)
• Jaundice
• Trouble keeping warm

There is also a higher risk of longer-term problems, including:

• Delayed motor and social development
• Learning disabilities
• Certain health conditions as an adult, such as heart disease, high blood pressure, diabetes, and obesity

Causes of high birth weight can include:

• Having big parents
• Diabetes in the pregnant parent
• Certain genetic conditions
• Too much weight gain during pregnancy

High birth weight can be a concern because it can make delivery of the baby difficult and raise the risk of birth injuries. The baby is at higher risk of problems with:

• Blood sugar
• Breathing problems
• Jaundice

You may be able to prevent some birth weight problems by:

• Getting regular checkups during pregnancy
• Getting the right amount of nutrition and calories during pregnancy
• Controlling your blood sugar if you have diabetes
• Avoiding substance use during pregnancy

Blood pressure is the force of your blood pushing against the walls of your arteries as your heart pumps blood. High blood pressure, or hypertension, is when this force against your artery walls is too high. There are different types of high blood pressure in pregnancy:

• Gestational hypertension is high blood pressure that you develop while you are pregnant. It starts after you are 20 weeks pregnant. You usually don't have any other symptoms. In many cases, it does not harm you or your baby, and it goes away within 12 weeks after childbirth. But it does raise your risk of high blood pressure in the future. It sometimes can be severe, which may lead to low birth weight or preterm birth. Some women with gestational hypertension do go on to develop preeclampsia.
• Chronic hypertension is high blood pressure that started before the 20th week of pregnancy or before you became pregnant. Some women may have had it long before becoming pregnant but didn't know it until they got their blood pressure checked at their prenatal visit. Sometimes chronic hypertension can also lead to preeclampsia.
• Preeclampsia is a sudden increase in blood pressure after the 20th week of pregnancy. It usually happens in the last trimester. In rare cases, symptoms may not start until after delivery. This is called postpartum preeclampsia. Preeclampsia also includes signs of damage to some of your organs, such as your liver or kidney. The signs may include protein in the urine and very high blood pressure. Preeclampsia can be serious or even life-threatening for both you and your baby.

The cause of preeclampsia is unknown.

You are at higher risk of preeclampsia if you:

• Had chronic high blood pressure or chronic kidney disease before pregnancy
• Had high blood pressure or preeclampsia in a previous pregnancy
• Have obesity
• Are over age 40
• Are pregnant with more than one baby
• Are African American
• Have a family history of preeclampsia
• Have certain health conditions, such as diabetes, lupus, or thrombophilia (a disorder which raises your risk of blood clots)
• Used in vitro fertilization, egg donation, or donor insemination

Preeclampsia can cause:

• Placental abruption, where the placenta separates from the uterus
• Poor fetal growth, caused by a lack of nutrients and oxygen
• Preterm birth
• A low birth weight baby
• Stillbirth
• Damage to your kidneys, liver, brain, and other organ and blood systems
• A higher risk of heart disease for you
• Eclampsia, which happens when preeclampsia is severe enough to affect brain function, causing seizures or coma
• HELLP syndrome, which happens when a woman with preeclampsia or eclampsia has damage to the liver and blood cells. It is rare, but very serious.

Possible symptoms of preeclampsia include:

• High blood pressure
• Too much protein in your urine (called proteinuria)
• Swelling in your face and hands. Your feet may also swell, but many women have swollen feet during pregnancy. So swollen feet by themselves may not be a sign of a problem.
• Headache that does not go away
• Vision problems, including blurred vision or seeing spots
• Pain in your upper right abdomen
• Trouble breathing

Eclampsia can also cause seizures, nausea and/or vomiting, and low urine output. If you go on to develop HELLP syndrome, you may also have bleeding or bruising easily, extreme fatigue, and liver failure.

Your health care provider will check your blood pressure and urine at each prenatal visit. If your blood pressure reading is high (140/90 or higher), especially after the 20th week of pregnancy, your provider will likely want to run some tests. They may include blood tests other lab tests to look for extra protein in the urine as well as other symptoms.

Delivering the baby can often cure preeclampsia. When making a decision about treatment, your provider take into account several factors. They include how severe it is, how many weeks pregnant you are, and what the potential risks to you and your baby are:

• If you are more than 37 weeks pregnant, your provider will likely want to deliver the baby.
• If you are less than 37 weeks pregnant, your health care provider will closely monitor you and your baby. This includes blood and urine tests for you. Monitoring for the baby often involves ultrasound, heart rate monitoring, and checking on the baby's growth. You may need to take medicines, to control your blood pressure and to prevent seizures. Some women also get steroid injections, to help the baby's lungs mature faster. If the preeclampsia is severe, you provider may want you to deliver the baby early.

The symptoms usually go away within 6 weeks of delivery. In rare cases, symptoms may not go away, or they may not start until after delivery (postpartum preeclampsia). This can be very serious, and it needs to be treated right away.

Do you know if your current weight is healthy? "Underweight", "normal", "overweight", and "obese" are all labels for ranges of weight. Obese and overweight mean that your weight is greater than it should be for your health. Underweight means that it is lower than it should be for your health. Your healthy body weight depends on your sex and height. For children, it also depends on your age.

A sudden, unexpected change in weight can be a sign of a medical problem. Causes for sudden weight loss can include:

• Thyroid problems
• Cancer
• Infectious diseases
• Digestive diseases
• Certain medicines

Sudden weight gain can be due to medicines, thyroid problems, heart failure, and kidney disease.

Good nutrition and exercise can help in losing weight. Eating extra calories within a well-balanced diet and treating any underlying medical problems can help to add weight.

Hyperthyroidism, or overactive thyroid, happens when your thyroid gland makes more thyroid hormones than your body needs.

Your thyroid is a small, butterfly-shaped gland in the front of your neck. It makes hormones that control the way the body uses energy. These hormones affect nearly every organ in your body and control many of your body's most important functions. For example, they affect your breathing, heart rate, weight, digestion, and moods. If not treated, hyperthyroidism can cause serious problems with your heart, bones, muscles, menstrual cycle, and fertility. But there are treatments that can help.

Hyperthyroidism has several causes. They include:

• Graves' disease, an autoimmune disorder in which your immune system attacks your thyroid and causes it to make too much hormone. This is the most common cause.
• Thyroid nodules, which are growths on your thyroid. They are usually benign (not cancer). But they may become overactive and make too much thyroid hormone. Thyroid nodules are more common in older adults.
• Thyroiditis, inflammation of the thyroid. It causes stored thyroid hormone to leak out of your thyroid gland.
• Too much iodine. Iodine is found in some medicines, cough syrups, seaweed and seaweed-based supplements. Taking too much of them can cause your thyroid to make too much thyroid hormone.
• Too much thyroid medicine. This can happen if people who take thyroid hormone medicine for hypothyroidism (underactive thyroid) take too much of it.

You are at higher risk for hyperthyroidism if you:

• Are a woman
• Are older than age 60
• Have been pregnant or had a baby within the past 6 months
• Have had thyroid surgery or a thyroid problem, such as goiter
• Have a family history of thyroid disease
• Have pernicious anemia, in which the body cannot make enough healthy red blood cells because it does not have enough vitamin B12
• Have type 1 diabetes or primary adrenal insufficiency, a hormonal disorder
• Get too much iodine, from eating large amounts of foods containing iodine or using iodine-containing medicines or supplements

The symptoms of hyperthyroidism can vary from person to person and may include:

• Nervousness or irritability
• Fatigue
• Muscle weakness
• Trouble tolerating heat
• Trouble sleeping
• Tremor, usually in your hands
• Rapid and irregular heartbeat
• Frequent bowel movements or diarrhea
• Weight loss
• Mood swings
• Goiter, an enlarged thyroid that may cause your neck to look swollen. Sometimes it can cause trouble with breathing or swallowing.

Adults over age 60 may have different symptoms than younger adults. For example, they may lose their appetite or withdraw from other people. Sometimes this can be mistaken for depression or dementia.

If hyperthyroidism isn't treated, it can cause some serious health problems, including:

• An irregular heartbeat that can lead to blood clots, stroke, heart failure, and other heart problems
• An eye disease called Graves' ophthalmopathy. It can cause double vision, light sensitivity, and eye pain. In rare cases, it can lead to vision loss.
• Thinning bones and osteoporosis
• Fertility problems in women
• Complications in pregnancy, such as premature birth, low birth weight, high blood pressure in pregnancy, and miscarriage

Your health care provider may use many tools to make a diagnosis:

• A medical history, including asking about symptoms
• A physical exam
• Thyroid tests, such as
  • TSH, T3, T4, and thyroid antibody blood tests
  • Imaging tests, such as a thyroid scan, ultrasound, or radioactive iodine uptake test. A radioactive iodine uptake test measures how much radioactive iodine your thyroid takes up from your blood after you swallow a small amount of it.

The treatments for hyperthyroidism include medicines, radioiodine therapy, and thyroid surgery:

• Medicines for hyperthyroidism include
  • Antithyroid medicines, which cause your thyroid to make less thyroid hormone. You probably need to take the medicines for 1 to 2 years. In some cases, you might need to take the medicines for several years. This is the simplest treatment, but it is often not a permanent cure.
  • Beta blocker medicines, which can reduce symptoms such as tremors, rapid heartbeat, and nervousness. They work quickly and can help you feel better until other treatments take effect.
• Radioiodine therapy is a common and effective treatment for hyperthyroidism. It involves taking radioactive iodine by mouth as a capsule or liquid. This slowly destroys the cells of the thyroid gland that produce thyroid hormone. It does not affect other body tissues. Almost everyone who has radioactive iodine treatment later develops hypothyroidism. This is because the thyroid hormone-producing cells have been destroyed. But hypothyroidism is easier to treat and causes fewer long-term health problems than hyperthyroidism.
• Surgery to remove part or most of the thyroid gland is done in rare cases. It might be an option for people with large goiters or pregnant women who cannot take antithyroid medicines. If you have all of your thyroid removed, you will need to take thyroid medicines for the rest of your life. Some people who have part of their thyroid removed also need to take medicines.

If you have hyperthyroidism, it's important not to get too much iodine. Talk to your health care provider about which foods, supplements, and medicines you need to avoid.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

During pregnancy, some common infections like the common cold or a skin infection do not usually cause serious problems. But other infections can be dangerous to you, your baby, or both. Some infections may lead to preterm birth and low birth weight babies. Others can cause serious illness, birth defects, and lifelong disabilities, such as hearing loss or learning problems.

Some of the infections that can be dangerous during pregnancy include:

• Bacterial vaginosis (BV)
• Group B strep (GBS)
• Hepatitis
• Sexually transmitted diseases
• Toxoplasmosis
• Urinary tract infections
• Yeast infections
• Zika virus

To try to prevent infections,:

• Don't eat raw or undercooked meat
• Don't share food or drinks with other people
• Wash your hands frequently
• Don't empty cat litter. Cats can transmit toxoplasmosis.

If you do get an infection during pregnancy, contact your health care provider about how best to protect you and your baby. Only some medicines are safe during pregnancy.

Iron is a mineral that our bodies need for growth and development. Your body uses iron to make hemoglobin, a protein in red blood cells. Hemoglobin carries oxygen from the lungs to all parts of the body. Iron is also important for healthy muscles, bone marrow, and organ function. Your body also needs iron to make some hormones.

Iron is found naturally in many foods and is added to some fortified food products. Foods that are high in iron include:

• Lean meat, seafood, and poultry
• Iron-fortified breakfast cereals and breads
• White beans, lentils, spinach, kidney beans, and peas
• Nuts and some dried fruits, such as raisins

Iron is available in supplements, either on its own or as part of many multivitamin/mineral supplements.

Most people in the United States get enough iron. The amount that you need each day depends on your age, your sex, and whether you consume a mostly plant-based diet.

Sometimes people can have trouble getting enough iron. There can be many causes, including blood loss, a poor diet, or a problem absorbing enough iron from foods. Those who are more likely to have low iron include people who:

• Have heavy periods
• Are pregnant or breastfeeding
• Are infants (especially if they were born premature or low birth weight)
• Are frequent blood donors
• Have cancer, certain digestive diseases, or heart failure
• Are on kidney dialysis
• Have trouble absorbing iron because they:
  • Have a digestive condition such as celiac disease, ulcerative colitis, Crohn's disease, or Helicobacter pylori infection
  • Had weight loss surgery

If you have too little iron, you may develop iron-deficiency anemia. It may not cause symptoms at first, but over time, it can cause fatigue, shortness of breath, and trouble with memory and concentration. Treatment for low iron and iron-deficiency anemia is usually with iron supplements.

Too much iron can damage your body. For example, if you are healthy and take too many iron supplements, you may have symptoms such as constipation, nausea and vomiting, abdominal (belly) pain, and diarrhea. Higher iron levels can cause ulcers. Extremely high levels can lead to organ damage, coma, and death.

A disease called hemochromatosis can cause too much iron to build up in the body. Hemochromatosis is inherited (passed down through families). It is usually treated by removing blood (and iron) from your body on a regular basis.

National Institutes of Health, Office of Dietary Supplements

You may need to take medicines while you are pregnant. But not all medicines are safe during pregnancy. Many medicines carry risks for you, your baby, or both. Opioids, especially when misused, can cause problems for you and your baby while you are pregnant.

Opioids, sometimes called narcotics, are a type of drug. They include strong prescription pain relievers such as oxycodone, hydrocodone, fentanyl, and tramadol. The illegal drug heroin is also an opioid.

A health care provider may give you a prescription opioid to reduce pain after you have had a major injury or surgery. You may get them if you have severe pain from health conditions like cancer. Some providers prescribe them for chronic pain.

Prescription opioids used for pain relief are generally safe when taken for a short time and as prescribed by your provider. However, people who take opioids are at risk for opioid use disorder (OUD) and overdose. These risks increase when these medicines are misused. Misuse can include taking your opioid medicines in greater amounts or more often than you are supposed to, using them to get high, or taking someone else's opioids.

Taking opioids during pregnancy can cause problems for you and your baby. The possible risks include:

• Neonatal abstinence syndrome (NAS) - withdrawal symptoms such as irritability, seizures, vomiting, diarrhea, fever, and poor feeding in newborns
• Neural tube defects - birth defects of the brain, spine, or spinal cord
• Congenital heart defects - problems with the structure of the baby's heart
• Gastroschisis - a birth defect of the baby's abdomen, where the intestines stick outside of the body through a hole beside the belly button
• Loss of the baby, either miscarriage (before 20 weeks of pregnancy) or stillbirth (after 20 or more weeks)
• Preterm delivery - a birth before 37 completed weeks of pregnancy
• Stunted growth, leading to low birthweight
• Problems with the placenta (the organ that brings oxygen and nutrients to the baby)

If your provider suggests that you take opioids during pregnancy, you should first discuss the risks and benefits. Then if you both decide that you need to take the opioids, you should work together to try to minimize the risks. Some of the ways to do this include:

• Taking them for the shortest time possible
• Taking the lowest dose that will help you
• Carefully following your provider's instructions for taking the medicines
• Contacting your provider if you have side effects
• Going to all your follow-up appointments

If you have been taking opioids and you become pregnant, contact your provider. But don't stop taking the opioids on your own. If you suddenly stop taking opioids, it could cause severe health problems for you or your baby. In some cases, stopping suddenly during pregnancy may be more harmful than taking the medicines.

If you regularly take opioid medicines, you may be able to breastfeed. It depends on which medicine you are taking. But you should not breastfeed if you have HIV or take illegal drugs. Check with your provider before breastfeeding.

If you are pregnant and have an opioid use disorder, do not stop taking opioids suddenly. Instead, see your provider so you can get help. The treatment for opioid use disorder (OUD) is called medication for opioid use disorder (MOUD). For MOUD during pregnancy, providers prescribe either buprenorphine or methadone. These medicines can reduce your cravings and help prevent withdrawal.

Counseling, including behavioral therapies, can also help you to change your attitudes and behaviors related to drug use and build healthy life skills.

During pregnancy, there are many things you can do to keep yourself and your baby healthy. They include getting regular prenatal care, eating healthy, and staying active. But it's also very important to avoid substances that could be harmful to you and your baby, such as tobacco, alcohol, and drugs.

Tobacco

Smoking during pregnancy passes nicotine, carbon monoxide, and many other harmful chemicals to your baby. Nicotine is not only a health danger for you, but it can also damage your developing baby's brain and lungs. Carbon monoxide can keep the developing baby from getting enough oxygen.

If you smoke while pregnant, it raises the risk of your baby being born too small, too early, or with birth defects. During the first year of life, there is a higher risk of your baby dying from sudden infant death syndrome (SIDS). And later in life, your child may be more likely to have health problems, such as asthma and obesity.

Other tobacco products, including e-cigarettes, also contain nicotine and are not safe to use during pregnancy. And some of the flavorings used in e-cigarettes may be harmful to developing babies.

You will also want to try to avoid secondhand smoke, which has some of the same risks as smoking during pregnancy.

Alcohol

There is no known amount of alcohol that is safe for you to drink during pregnancy and while trying to get pregnant. All types of alcohol are equally harmful, including all wines and beer. The risks from drinking during pregnancy include problems with the growth of the developing baby and fetal alcohol spectrum disorders (FASD). FASD is a life-long condition that can cause a mix of physical, behavioral, and learning problems.

Illegal drugs

Using illegal drugs, such as cocaine, methamphetamines, and club drugs, during pregnancy can cause problems for both you and your baby. They may cause low birth weight babies, birth defects, or miscarriage. Your child may be more likely to have learning and developmental disabilities. And if you are injecting the drugs, that puts you at risk for HIV. HIV can be passed along to your baby during pregnancy.

Prescription drug misuse

Misusing prescription drugs can also be harmful. Misuse can include taking more than your prescribed dose or taking it more often, using it to get high, or taking someone else's medicines. The possible effects of misusing a medicine during pregnancy will depend on which medicine you are misusing.

Opioids

One type of drug that is a concern during pregnancy is opioids. Opioids include strong prescription pain relievers such as oxycodone, hydrocodone, fentanyl, and tramadol. The illegal drug heroin is also an opioid. Taking opioids during pregnancy can cause problems for you and your baby. The risks include birth defects, preterm birth, the loss of the baby, and neonatal abstinence syndrome (NAS). NAS causes withdrawal symptoms in newborn babies.

If you have pain and your health care provider suggests that you take prescription opioids during pregnancy, first discuss the risks and benefits with the provider. Then if you both decide that you need to take the opioids, you can work together to try to minimize the risks.

Cannabis (marijuana)

Getting help

If you are taking opioids or are addicted to drugs, don't stop taking them suddenly. That can be dangerous to you and the baby. Instead, contact your provider for help with getting off the drugs safely.

Almost 1 of every 10 infants born in the United States are premature, or preemies. A premature birth is when a baby is born before 37 completed weeks of pregnancy. A full-term pregnancy is 40 weeks.

Important growth and development happen throughout pregnancy - especially in the final months and weeks. Because they are born too early, preemies weigh much less than full-term babies. They may have health problems because their organs did not have enough time to develop. Problems that a baby born too early may have include:

• Breathing problems
• Feeding difficulties
• Cerebral palsy
• Developmental delay
• Vision problems
• Hearing problems

Preemies need special medical care in a neonatal intensive care unit, or NICU. They stay there until their organ systems can work on their own.

Centers for Disease Control and Prevention

Shingles (herpes zoster) is an infection that causes a painful rash. It is caused by the varicella-zoster virus (VZV). This is the same virus that causes chickenpox. After you have chickenpox, the virus stays in your body. It may not cause problems for many years. But as you get older, the virus may become active again and cause shingles.

Shingles is not contagious. You cannot get shingles from someone else. But you can catch chickenpox from someone with shingles if you have direct contact with fluid from their shingles rash.

The risk of spreading the virus is low if the shingles rash is kept covered. People with shingles cannot spread the virus before their rash blisters appear or after the rash crusts.

Anyone who has had chickenpox can get shingles. But the risk of shingles goes up as you get older. Shingles is most common in people over age 50.

People with weakened immune systems are at higher risk of getting shingles. This includes those who:

• Have immune system diseases such as HIV
• Have certain cancers
• Take medicines that weaken their immune system, such as steroids and medicines you take after organ transplant

Your immune system may be weaker when you have an infection or are stressed. This can raise your risk of shingles.

It is rare, but possible, to get shingles more than once.

Early signs of shingles include burning or shooting pain and tingling or itching. It is usually on one side of the body or face. The pain can be mild to severe.

Up to several days later, you will get a rash. It consists of blisters that typically scab over in 7 to 10 days. The rash is usually a single stripe around either the left or the right side of the body. In other cases, the rash is only on one side of the face. In rare cases (usually among people with weakened immune systems), the rash may be more widespread. It might look similar to a chickenpox rash.

Some people may also have other symptoms:

• Fever
• Headache
• Chills
• Upset stomach

Shingles can cause other problems (complications):

• Postherpetic neuralgia (PHN) is most common complication of shingles. It causes severe pain in the areas where you had the shingles rash. It usually gets better in a few weeks or months. But some people can have pain from PHN for many years, and it can interfere with daily life.
• Vision loss can happen if shingles affects your eye. It may be temporary or permanent.
• Hearing or balance problems are possible if you have shingles within or near your ear. You may also have weakness of the muscles on that side of your face. These problems can be temporary or permanent.

Very rarely, shingles can also lead to pneumonia, brain inflammation (encephalitis), or death.

Usually your health care provider can diagnose shingles by taking your medical history and looking at your rash. In some cases, your provider may scrap off tissue from the rash or swab some fluid from the blisters and send the sample to a lab for testing.

There is no cure for shingles. Antiviral medicines may help to make the attack shorter and less severe. They may also help prevent PHN. The medicines are most effective if you can take them within 3 days after the rash appears. So if you think you might have shingles, contact your provider as soon as possible.

Pain relievers may also help with the pain. A cool washcloth, calamine lotion, and oatmeal baths may help relieve some of the itching.

There is a vaccine, called Shingrix, to help prevent shingles and its complications. The Centers for Disease Control and Prevention recommends that healthy adults 50 years and older get the vaccine. Your provider might also recommend the vaccine if you are over 19 and have a weakened immune system. The vaccine is given in two doses.

If you have shingles, you can help prevent spreading the virus to others by:

• Staying away from:
  • People with weakened immune systems
  • People who have not had chickenpox or the chickenpox vaccine, especially if they are pregnant
  • Premature or low birth weight babies
• Keeping the rash covered
• Not touching or scratching the rash
• Washing your hands often

Centers for Disease Control and Prevention