High-Risk Pregnancy: Why Diet, Exercise and Stress Matter

Good nutrition is important to every pregnancy, but it becomes even more critical when risks are elevated. A well-balanced diet helps support fetal growth, regulate blood sugar, maintain healthy blood pressure and reduce inflammation. All of these are key concerns in many high-risk situations.

Adequate protein intake supports healthy tissue growth for both mother and baby. Complex carbohydrates, such as whole grains, fruits and vegetables, provide energy and help stabilize blood sugar levels. This is especially important for women with pre-existing diabetes or gestational diabetes, which develops during pregnancy.

Healthy fats — like those found in avocados, nuts, seeds and fatty fish low in mercury — support fetal brain development and may reduce inflammation. Conversely, highly processed foods, excess sugar and excessive sodium can worsen conditions like hypertension and diabetes.

“In high-risk pregnancies, nutritional needs can be more specific and deficiencies may have greater consequences,” says Jasmine Lai, MD, an OB-GYN and maternal and fetal medicine specialist at Scripps Clinic La Jolla-Poole Building. “Micronutrients also matter. Iron, for example, helps prevent anemia. Folate supports neural tube development and can help prevent birth defects.”

For women with high-risk pregnancies, exercise may seem questionable. However, in many cases — and with medical approval — appropriate physical activity can offer significant benefits.

Gentle to moderate exercise can help support cardiovascular health, regulate blood sugar, improve circulation and manage weight. Low-impact activities, such as walking, prenatal yoga, swimming or stationary cycling, are often well tolerated.

Exercise can also reduce the risk of health problems, such as gestational diabetes or preeclampsia, a complication related to high blood pressure. In addition, exercise can help reduce stress and support mental well-being. Exercising outdoors in nature can provide an extra mood boost.

That said, exercise is not appropriate during every high-risk pregnancy.

“Certain conditions, such as preterm labor risk or severe hypertension, may require strict limitations or bed rest,” Dr. Lai says. “Each woman should consult with her physician to understand the specific risks involved and get personalized guidance and recommendations.”

Everyone feels stress, but chronic or unmanaged stress can make a high-risk pregnancy more challenging. When the body is under significant stress, it releases hormones, such as cortisol and adrenaline. Over time, elevated levels of these hormones may contribute to higher blood pressure, blood sugar problems, sleep disturbances and inflammation.

“Research has linked high stress levels during pregnancy with increased risks of preterm birth, low birth weight and complications such as preeclampsia,” Dr. Lai says. “A high-risk pregnancy is stressful in itself, so try to minimize other sources of stress.”

Learning to manage stress doesn’t mean eliminating it. Instead, find tools that help you cope effectively, such as breathing exercises, meditation, music or sound therapy, or whatever helps you relax. Look for positive support from partners, family or friends.

A good diet, appropriate exercise and stress management form a lifestyle “trifecta” that helps support both physical and emotional health during a high-risk pregnancy. While optimizing these lifestyle factors cannot eliminate all risks, they can help enhance the body’s ability to respond to medical treatment and support a healthier pregnancy.