Abstract Rationale Previous studies have reported that exposure to fine particulate matter (PM2·5) is associated with adverse pregnancy outcomes. However, the effects of long-term preconception exposure to PM2·5 on the maternal and fetal outcomes of pregnant women with pulmonary hypertension (PH) are unknown. Methods We examined the clinical outcomes of pregnant women with PH who were admitted from January 1, 2013, to August 1, 2022, to 24 tertiary hospitals in China. Three-year average preconception exposure and monthly average postconception exposure to PM2·5 were assessed by satellite-based PM2·5 concentrations at a 1-km spatial resolution for each participant. Multivariable logistic regression was used to examine the associations between PM2·5 exposure and maternal and fetal cohorts, with adjustments made for maternal baseline demographics, PH severity, and obstetric events. Results We identified 717 participants in the analysis of the maternal cohort. Compared with the first tertile, the Odds Ratio (OR) of maternal death and/or heart failure (HF) associated with the second and third tertiles were 2·32 (95% CI, 1·36-4·02) and 1·87 (95% CI, 1·08-3·28), respectively. The OR was 1·95 (95% CI, 1·16-3·34) during the postconception period. With respect to offspring outcomes, 131 cases of pregnancy loss were excluded. Thus, a total of 586 newborns were included in the fetal cohort. The risk of the main adverse fetal outcomes including preterm birth (PTB) and/or low birth weight (LBW) was associated with PM2·5 levels during both the preconception and postconception periods. Conclusion This retrospective cohort study revealed that long-term preconception exposure and monthly postconception exposure to PM2·5 increased the risk of maternal and fetal outcomes. This abstract is funded by: None
Huang et al. (2026) studied this question.