Outcomes in Pregnant Women Diagnosed with Preeclampsia with and Without Fetal Growth Restriction at High Altitude: A Cross-Sectional Study and Literature Review

Background:

Preeclampsia (PE) and fetal growth restriction (FGR) are major contributors to maternal and neonatal morbidity

and mortality globally. The pathophysiology of these conditions is further complicated by high-altitude (HA)

environments due to hypoxia-induced changes in maternal and fetal physiology. This study aimed to evaluate

the maternal and neonatal outcomes of PE, with and without FGR, in a HA setting (Bogotá, Colombia, 2,640

m.a.s.l.).

Methods:

This retrospective, cross-sectional study analyzed 437 patients diagnosed with PE between 2020 and 2023.

Participants were stratified into groups with and without FGR based on established diagnostic criteria. Data

were collected from electronic medical records. Variables included maternal clinical features, neonatal

outcomes, and severity of PE manifestations.

Findings:

Among patients, 18.76% had PE with FGR. This subgroup exhibited earlier onset of PE (median 33.1 vs. 36.6

weeks), higher cesarean delivery rates (87.8% vs. 75%), and lower neonatal birth weights (median 1,655 g vs.

2,700 g). Severe maternal complications, such as hepatic and renal involvement, were more frequent in the PE

+ FGR group. Neonates from this group had higher rates of NICU admission (87% vs. 65.6%) and neonatal

mortality (7.32% vs. 1.13%).

Interpretation:

High altitude exacerbates the severity of PE and FGR, with significant implications for maternal and neonatal

outcomes. These findings highlight the need for tailored clinical protocols in HA populations and underscore

the importance of further research into genetic and adaptive mechanisms influencing these conditions. Future

studies should explore longitudinal outcomes and biomarkers to refine risk stratification and management

strategies for HA residents.