Maternal and neonatal outcomes in pregnancies complicated with pulmonary hypertension: a retrospective cohort study

To evaluate the maternal and neonatal outcomes of pregnancy complicated with pulmonary hypertension.

We reviewed and analyzed the clinical data of 70 pregnant women with PH admitted to the First Affiliated Hospital of Zhengzhou University from January 2012 to December 2022. The data extracted included general characteristics, laboratory findings, imaging manifestations, and maternal and perinatal outcomes. PH was diagnosed via echocardiography, and patients were categorized into mild and moderate-to-severe PH groups on the basis of pulmonary artery systolic pressure (sPAP). Cardiac function was graded according to the World Health Organization Functional Class (WHO-FC).

The mean age of the patients was 29.83 ± 5.81 years. A total of 55.71% were primigravida, and 44.29% were multigravida. The majority of patients (65.71%) had regular obstetric examinations during pregnancy. There were statistically significant differences in BNP levels, right ventricular diastolic diameter (RVDD), and WHO-FC between the mild and moderate-to-severe PH groups. The majority of patients (87.50% vs. 86.67%) underwent cesarean section, with regional anesthesia used in 70.00% of the patients. The maternal mortality rate was 5.71% (4/70) in women with severe PH. The median gestational age at delivery was 36.57 weeks for mild PH group and 33.93 weeks for moderate-to-severe PH group, respectively. Fetal birth weight was significantly lower in the moderate-to-severe PH group. A greater proportion of infants in the moderate-to-severe PH group were admitted to the neonatal intensive care unit (NICU) and had low birth weights (LBWs).

Pregnancy complicated with PH poses a significant risk to both maternal and neonatal health, with poorer outcomes associated with moderate-to-severe PH. Multidisciplinary management, early detection, and timely intervention are crucial for improving outcomes. This study underscores the importance of individualized care plans and the need for further research to refine the predictive factors for the prognosis of PH-complicated pregnancies.