Long-term maternal and fetal outcomes of pulmonary hypertension in pregnancy in the southwest plateau area of China: a retrospective study

Abstract Objective The objective was to investigate maternal, obstetric, and neonatal outcomes of pulmonary hypertension (PH) in pregnancy based on different altitudes of residence in the southwest plateau area of China. Methods Data were collected from pregnant women with PH admitted to The First P...

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Main Authors: XinDan Zhang, LiLi Tao, XiaoMing Yin, Wei Huang, Pu Li
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Pulmonary Medicine
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Online Access:https://doi.org/10.1186/s12890-025-03729-3
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author XinDan Zhang
LiLi Tao
XiaoMing Yin
Wei Huang
Pu Li
author_facet XinDan Zhang
LiLi Tao
XiaoMing Yin
Wei Huang
Pu Li
author_sort XinDan Zhang
collection DOAJ
description Abstract Objective The objective was to investigate maternal, obstetric, and neonatal outcomes of pulmonary hypertension (PH) in pregnancy based on different altitudes of residence in the southwest plateau area of China. Methods Data were collected from pregnant women with PH admitted to The First People’s Hospital of Yunnan Province from January 1, 2012, to December 31, 2021. All pregnant women with PH were diagnosed via echocardiography according to a pulmonary arterial systolic pressure > 30 mmHg. Patients were classified into three groups according to the altitude of residence during pregnancy. Demographic characteristics, maternal and neonatal outcomes, complications, and follow-up outcomes after discharge were reported. Results Fifty-two pregnant women with PH were included. Among the included women, eleven (21.2%) were in the low-altitude group, twenty-six (50.0%) were in the medium-altitude group, and fifteen (28.8%) were in the high-altitude group. The overall mortality rate was 5.8%: death up to 6 weeks after delivery occurred in one patient (1.9%), and the other two patients (4.9%) died within one to four years after delivery. Preterm delivery occurred in 22 (42.3%) patients. The incidences of maternal death (11.5% vs. 0.0, p < 0.01), cesarean delivery (80.8% vs. 70.7% vs. 80.0%, p = 0.001), and live birth (84.6% vs. 72.7% vs. 80.0%, p < 0.01) were higher in the medium-altitude group than in the low- and high-altitude groups. Therapeutic abortion was performed in 15.4% of the women, with the highest rate in the high-altitude group (p < 0.01). The rates of heart failure and respiratory failure were highest in the low-altitude group (p < 0.01). No fetal death occurred, and 22 neonates (42.3%) had a low birth weight. During a median follow-up of 2.4 years, two patients died (4.9%), and seven (17.1%) still had PH. Conclusion The in-hospital mortality rate of pregnant women with PH in the plateau area is similar to that previously reported in the low-altitude region, but the long-term survival rate is lower. Therapeutic abortion is also higher in pregnant women with a high altitude of residence. These findings highlight that the risks associated with PH in pregnancy persist beyond delivery and underscore the importance of early risk assessment, rigorous multidisciplinary management, and prolonged postpartum follow-up, especially in plateau populations with limited access to specialized care.
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spelling doaj-art-9bd03f07285145a3a40e6cc46af74dea2025-08-20T02:00:08ZengBMCBMC Pulmonary Medicine1471-24662025-05-0125111410.1186/s12890-025-03729-3Long-term maternal and fetal outcomes of pulmonary hypertension in pregnancy in the southwest plateau area of China: a retrospective studyXinDan Zhang0LiLi Tao1XiaoMing Yin2Wei Huang3Pu Li4Department of General Practice, The First People’s Hospital of Yunnan ProvinceDepartment of General Practice, The First People’s Hospital of Yunnan ProvinceDepartment of General Practice, The First People’s Hospital of Yunnan ProvinceDepartment of Cardiovascular, The First Affiliated Hospital of ChongQing Medical UniversityDepartment of General Practice, The First People’s Hospital of Yunnan ProvinceAbstract Objective The objective was to investigate maternal, obstetric, and neonatal outcomes of pulmonary hypertension (PH) in pregnancy based on different altitudes of residence in the southwest plateau area of China. Methods Data were collected from pregnant women with PH admitted to The First People’s Hospital of Yunnan Province from January 1, 2012, to December 31, 2021. All pregnant women with PH were diagnosed via echocardiography according to a pulmonary arterial systolic pressure > 30 mmHg. Patients were classified into three groups according to the altitude of residence during pregnancy. Demographic characteristics, maternal and neonatal outcomes, complications, and follow-up outcomes after discharge were reported. Results Fifty-two pregnant women with PH were included. Among the included women, eleven (21.2%) were in the low-altitude group, twenty-six (50.0%) were in the medium-altitude group, and fifteen (28.8%) were in the high-altitude group. The overall mortality rate was 5.8%: death up to 6 weeks after delivery occurred in one patient (1.9%), and the other two patients (4.9%) died within one to four years after delivery. Preterm delivery occurred in 22 (42.3%) patients. The incidences of maternal death (11.5% vs. 0.0, p < 0.01), cesarean delivery (80.8% vs. 70.7% vs. 80.0%, p = 0.001), and live birth (84.6% vs. 72.7% vs. 80.0%, p < 0.01) were higher in the medium-altitude group than in the low- and high-altitude groups. Therapeutic abortion was performed in 15.4% of the women, with the highest rate in the high-altitude group (p < 0.01). The rates of heart failure and respiratory failure were highest in the low-altitude group (p < 0.01). No fetal death occurred, and 22 neonates (42.3%) had a low birth weight. During a median follow-up of 2.4 years, two patients died (4.9%), and seven (17.1%) still had PH. Conclusion The in-hospital mortality rate of pregnant women with PH in the plateau area is similar to that previously reported in the low-altitude region, but the long-term survival rate is lower. Therapeutic abortion is also higher in pregnant women with a high altitude of residence. These findings highlight that the risks associated with PH in pregnancy persist beyond delivery and underscore the importance of early risk assessment, rigorous multidisciplinary management, and prolonged postpartum follow-up, especially in plateau populations with limited access to specialized care.https://doi.org/10.1186/s12890-025-03729-3Pulmonary hypertensionPregnancyPlateau area
spellingShingle XinDan Zhang
LiLi Tao
XiaoMing Yin
Wei Huang
Pu Li
Long-term maternal and fetal outcomes of pulmonary hypertension in pregnancy in the southwest plateau area of China: a retrospective study
BMC Pulmonary Medicine
Pulmonary hypertension
Pregnancy
Plateau area
title Long-term maternal and fetal outcomes of pulmonary hypertension in pregnancy in the southwest plateau area of China: a retrospective study
title_full Long-term maternal and fetal outcomes of pulmonary hypertension in pregnancy in the southwest plateau area of China: a retrospective study
title_fullStr Long-term maternal and fetal outcomes of pulmonary hypertension in pregnancy in the southwest plateau area of China: a retrospective study
title_full_unstemmed Long-term maternal and fetal outcomes of pulmonary hypertension in pregnancy in the southwest plateau area of China: a retrospective study
title_short Long-term maternal and fetal outcomes of pulmonary hypertension in pregnancy in the southwest plateau area of China: a retrospective study
title_sort long term maternal and fetal outcomes of pulmonary hypertension in pregnancy in the southwest plateau area of china a retrospective study
topic Pulmonary hypertension
Pregnancy
Plateau area
url https://doi.org/10.1186/s12890-025-03729-3
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