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Balancing Risk and Hope: Insights Into Pregnancy Outcomes in Pulmonary Arterial Hypertension
Teresa Segura de la Cal1, Carmen Pérez-Olivares2, Raquel Luna-López3
1Adult Congenital Heart Disease Unit and Pulmonary Hypertension Unit, Department of Cardiology. ERN-Lung (European Reference Network on Rare Respiratory Diseases) Hospital Universitario 12 de Octubre Madrid Spain.
Pulmonary Circulation
|June 8, 2026
Summary
Pregnancy in women with Pulmonary Arterial Hypertension (PAH) carries risks. Vasoreactive PAH patients have better outcomes, suggesting tailored management is needed for this group.
Area of Science:
- Cardiology
- Pulmonology
- Obstetrics
Background:
- Pregnancy is high-risk for Pulmonary Arterial Hypertension (PAH) patients.
- Modern management has improved outcomes, but risks remain.
- Vasoreactive status in PAH during pregnancy needs further investigation.
Purpose of the Study:
- To evaluate maternal and neonatal outcomes in a contemporary PAH cohort.
- To compare outcomes between vasoreactive and non-vasoreactive PAH patients.
- To determine if vasoreactive status warrants distinct clinical recommendations.
Main Methods:
- Retrospective, longitudinal cohort study.
- Inclusion of PAH pregnancies managed from 2010-2023.
- Comparison of clinical characteristics, maternal/neonatal complications, and long-term outcomes between vasoreactive and non-vasoreactive groups.
Main Results:
- Non-vasoreactive patients had significantly higher major (35.7%) and minor (92.9%) complication rates.
- Non-vasoreactive subgroup required prostacyclin, inotropic, and mechanical circulatory support, with one death.
- Neonates of non-vasoreactive mothers were predominantly preterm with higher complication rates (84.6%).
Conclusions:
- Pregnancy in PAH, even with modern management, is linked to significant maternal and neonatal morbidity.
- Vasoreactive PAH patients demonstrate a favorable prognosis for both mother and child.
- Tailored clinical recommendations for vasoreactive PAH pregnancies are suggested.
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