One of the most common questions we get here is, how likely am I to get preeclampsia/HELLP again? Here are the statistics researchers have compiled.
Most women who get preeclampsia only get it once. The overall recurrence rate is around 20%, which means 80% do not get it again. Of those who get it more than once, most get it later and milder the second time. There is a lot of hope for a happy outcome, even if you get preeclampsia again.
An individual's risk may be higher or lower than that average depending on their circumstances. The biggest factors seem to be how early you had to deliver and whether you have any known underlying conditions. The final risk range goes from 5% to 80% for various subgroups. HELLP has a lower recurrence risk range from 2% to 20%, again depending on circumstances.
We often advise women to meet with a Maternal Fetal Medicine specialist for a preconception appointment. They are the experts in high risk pregnancies. They can review your history, recommend any testing for underlying conditions, and give you a more personalized risk profile. Find our suggested questions to ask your doctor here.
But no one can tell you which side of the odds you'll fall, whether you will or won't actually get preeclampsia/HELLP again. Statistics are useful for seeing trends in large groups, and can be useful in making decisions, but they ultimately tell you nothing about what will happen to you as an individual.
Because for the lowest risk group who only have a 5% risk, if you happen to be part of the 5%, you get preeclampsia, 100%. And for the highest risk group who have an 80% risk, if you happen to be part of the 20%, you do not get preeclampsia, 0%. During our 10+ years in preeclampsia support groups, we have seen very high risk women who end up totally fine, and very low risk women who are The One Rare Case.
The uncertainty and not knowing can be very hard to live with, and anxiety in second pregnancies is often high. No matter how high or low your personal risk is, you should be monitored closely and take any symptoms seriously. If preeclampsia does happen again (and it may not), catching it as early as possible gives you the best chance at a happy outcome. And if the anxiety gets overwhelming, please do not hesitate to reach out for help. Therapy and/or medication can do wonders.