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Cited by 244Pregnancy and preeclampsia studiesHigh Altitude and HypoxiaNeurological Complications and Syndromes

Altered blood pressure course during normal pregnancy and increased preeclampsia at high altitude (3100 meters) in Colorado

Palmer, Susan K., Moore, Lorna G., Young, David A., Cregger, Betsy, Berman, Jonathan C., Zamudio, Stacy·1999·American Journal of Obstetrics and Gynecology
DOI 10.1016/s0002-9378(99)70611-3
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Abstract

Objective Our purpose was to determine the case incidences of preeclampsia at low and high altitudes and whether maternal blood pressure course during pregnancy differs between low and high altitudes.Study design This was a retrospective cohort study of pregnancies in sociodemographically matched communities at low and high altitudes in Colorado; each community had a small hospital served by family practitioners and was located >100 miles from major urban areas. Included were consecutive singleton pregnancies of women without chronic disease that resulted in live-born infants at >28 weeks' gestation during an 18-month period (n = 116 at 1260 m, n = 93 at 3100 m). Clinic and hospital medical records were searched and data pertaining to hypertensive complications of pregnancy and serial blood pressure measurements were abstracted.Results Despite similar maternal risk factors, the case incidences of preeclampsia were 16% at 3100 m and 3% at 1260 m. As in sea-level pregnancies, mean blood pressure fell until week 20 in normotensive pregnancy at 1260 m. Mean pressure rose linearly, however, in normotensive women at 3100 m and in women with preeclampsia at both 1260 m and 3100 m. High altitude acted independently of known risk factors and yielded an odds ratio for preeclampsia of 3.6 (95% confidence interval 1. 1-11.9). Birth weight was 285 g lower at 3100 m despite similar gestational ages.Conclusion The normal pregnancy-associated fall in blood pressure was absent at 3100 m, even in women who remained normotensive. The incidence of preeclampsia was increased at high altitude. Residence at high altitude interferes with the normal vascular adjustments to pregnancy, increasing the incidence of preeclampsia, and is perhaps analogous to other conditions that decrease uteroplacental oxygen delivery.

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  • This suggests that remodelling of the uterine arteries during human pregnancy is impaired at high altitude, in line with the greater incidence of preeclampsia in these populations.

    “This suggests that remodelling of the uterine arteries during human pregnancy is impaired at high altitude (532), in line with the greater incidence of preeclampsia in these populations (429).”

    From Placental Origins of Chronic Disease (2016) · cites this paper as [429]

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Authors
Palmer, S. K., Moore, L. G., Young, D. A., Cregger, B., Berman, J. C., & Zamudio, S.
Affiliations
  • University of Colorado Health (US)
  • University of Colorado Denver (US)
ORCID
Venue
American Journal of Obstetrics and Gynecology
Publisher
Elsevier BV
Published
1999-05
Volume
180
Issue
5
Pages
1161-1168
ISSN
0002-9378 (ISSN-L)
DOI
10.1016/s0002-9378(99)70611-3
OpenAlex
W2009346631
Cited by
244
References
30
Citations by year
2026: 8 · 2025: 7 · 2024: 7 · 2023: 9 · 2022: 11 · 2021: 10 · 2020: 13 · 2019: 3 · 2018: 16 · 2017: 10 · 2016: 10 · 2015: 13 · 2014: 6 · 2013: 10 · 2012: 8
FWCI
6.51
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • American Journal of Obstetrics and Gynecology (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Heart, Lung, and Blood Institute (HLB-5F32BL08774, HLB-14985, HLB-0717)
Topics
  • Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › High Altitude and Hypoxia
  • Health Sciences › Medicine › Psychiatry and Mental health › Neurological Complications and Syndromes
Keywords
preeclampsia, high altitude, maternal blood pressure, pregnancy, birth weight
MeSH terms
Adolescent, Adult, Altitude, Birth Weight, Blood Pressure, Body Height, Colorado, Female, Humans, Hypertension, Poverty, Pre-Eclampsia, Pregnancy, Pregnancy Complications, Cardiovascular, Regression Analysis, Retrospective Studies, Risk Factors, Cohort Studies

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