Pregnancy outcomes at high-altitude regions in Saudi Arabia; a retrospective study

Abstract

Background: High altitude associated with chronic hypoxia affects 140 million individuals in the world living at 8,000 feet or higher. This study was aimed at determining the outcomes of pregnancy at high-altitude regions compared to the regions at the sea level. Methodology: A retrospective study was conducted in King Abdulaziz Special Hospital in Taif region and Maternity and Children\'s Hospital at Jeddah between 2012 and 2015. A total of 658 pregnant women and their newborns were enrolled; 329 pregnant women and their newborns living at high-altitude area (from Taif city) and 329 living at sea level area (Jeddah city). Data were analyzed using Statistical Package for the Social Sciences version 16.0. Chi-Square tests were performed to compare the different categorical parameters. Results: Gestational Diabetes Mellitus was found significantly increased (p = 0.006) in pregnant women residing at high altitude (3.01%) compared to those at sea level (0.3%). Mode of delivery was significantly different (p < 0.001) between high altitude and sea level, as 81.76% reported spontaneous vaginal delivery (SVD), 15.2% lower segment caesarean section (LSCS), 0.30% breech presentation (BP), and 2.74% vacuum extraction (VE) at high altitude compared to 60.49% SVD, 38.91% LSCS, 0.61% BP, and 0% VE, respectively, at sea-level residents. Gestational age was significantly higher (p < 0.001) in high altitude (38.14 ± 2.47 weeks) compared to sea level (37.46 ± 29 weeks). Term birth was significantly higher (p = 0.002) in high altitude, as 13.98% at high altitude showed preterm birth compared to 23.1% at sea level. Apgar Score 1 was significantly less frequently reported (p < 0.05) at high altitude residents (7.7 ± 1.4) compared to the sea level (9.47 ± 1.72) residents. Conclusion: The study findings concluded that babies born to sea level residents was healthier compared to those residing at high altitudes. Therefore, more health care is warranted during the delivery of high-altitude residents.