{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T05:17:30Z","timestamp":1783574250547,"version":"3.55.0"},"reference-count":27,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,5,24]],"date-time":"2026-05-24T00:00:00Z","timestamp":1779580800000},"content-version":"vor","delay-in-days":53,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["CM23\/00235"],"award-info":[{"award-number":["CM23\/00235"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["JR23\/00071"],"award-info":[{"award-number":["JR23\/00071"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pulm. circ."],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Pregnancy poses substantial risks for women with Pulmonary Arterial Hypertension (PAH). This study aimed to evaluate maternal and neonatal outcomes in a contemporary PAH cohort under modern management, specifically investigating whether vasoreactive status warrants distinct clinical recommendations. We conducted a retrospective, longitudinal cohort study of PAH pregnancies managed at our institution between February 2010 and December 2023, comparing clinical characteristics, maternal complications, long\u2010term outcomes, and neonatal parameters between vasoreactive and non\u2010vasoreactive patients. Among 29 patients, 8 underwent pregnancy termination, and 21 proceeded with the pregnancy; 7 (33.3%) of whom were vasoreactive. Non\u2010vasoreactive patients experienced significantly higher rates of major complications (35.7% vs. 0%,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.039) and minor complications (92.9% vs. 0%,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). Complications in the non\u2010vasoreactive subgroup included prostacyclin initiation (78.6%), inotropic support (35.7%), mechanical circulatory support (14.3%), and one death (7.14%). All neonates born to non\u2010vasoreactive patients were delivered preterm and showed a trend toward higher complication rates (84.6% vs. 42.9%,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.054). Over a median 5\u2010year follow\u2010up, two non\u2010vasoreactive patients died, whereas none of the vasoreactive patients lost their vasoreactive profile. In conclusion, despite advances in management, pregnancy in PAH remains associated with substantial maternal and neonatal morbidity. Vasoreactive patients, however, exhibit a distinctly favorable prognosis for both mother and offspring, which suggest the need for tailored recommendations for this subgroup.\n                  <\/jats:p>","DOI":"10.1002\/pul2.70327","type":"journal-article","created":{"date-parts":[[2026,5,24]],"date-time":"2026-05-24T09:34:13Z","timestamp":1779615253000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Balancing Risk and Hope: Insights Into Pregnancy Outcomes in Pulmonary Arterial Hypertension"],"prefix":"10.1002","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0269-5574","authenticated-orcid":false,"given":"Teresa","family":"Segura de la Cal","sequence":"first","affiliation":[{"name":"Adult Congenital Heart Disease Unit and Pulmonary Hypertension Unit, Department of Cardiology. ERN\u2010Lung (European Reference Network on Rare Respiratory Diseases) Hospital Universitario 12 de Octubre Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"P\u00e9rez\u2010Olivares","sequence":"additional","affiliation":[{"name":"Department of Cardiology Henares University Hospital Coslada Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1842-929X","authenticated-orcid":false,"given":"Raquel","family":"Luna\u2010L\u00f3pez","sequence":"additional","affiliation":[{"name":"Department of Cardiology of Hospital Clinic and Hospital Sant Joan de Deu, Hospital Clinic Barcelona Hospital Sant Joan de Deu Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Mart\u00edn de Miguel","sequence":"additional","affiliation":[{"name":"Adult Congenital Heart Disease Unit and Pulmonary Hypertension Unit, Department of Cardiology. ERN\u2010Lung (European Reference Network on Rare Respiratory Diseases) Hospital Universitario 12 de Octubre Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3851-4037","authenticated-orcid":false,"given":"Alejandro","family":"Cruz\u2010Utrilla","sequence":"additional","affiliation":[{"name":"Pulmonary Hypertension Unit, Department of Cardiology. ERN\u2010LUNG (European Reference Network on Rare Respiratory Diseases). CIBERCV (Centro de Investigaci\u00f3n Biom\u00e9dica en Red en Enfermedades Cardiovasculares) Hospital Universitario 12 de Octubre Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Villar","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Hospital Universitario 12 de Octubre Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Sarnago","sequence":"additional","affiliation":[{"name":"Adult Congenital Heart Disease Unit, Department of Cardiology Hospital Universitario 12 de Octubre Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology Hospital Universitario 12 de Octubre Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Santiago S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology Hospital Universitario 12 de Octubre Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Jes\u00fas","family":"L\u00f3pez Gude","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery Hospital Universitario 12 de Octubre Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maite","family":"Vel\u00e1zquez","sequence":"additional","affiliation":[{"name":"Cardiology Department and CIBERCV (Centro de Investigaci\u00f3n Biom\u00e9dica en Red en Enfermedades Cardiovasculares) Hospital Universitario 12 de Octubre Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Forc\u00e9n","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Hospital Universitario 12 de Octubre Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan F.","family":"Delgado","sequence":"additional","affiliation":[{"name":"Heart Failure and Heart Transplant Unit, Department of Cardiology, and CIBERCV (Centro de Investigaci\u00f3n Biom\u00e9dica en Red en Enfermedades Cardiovasculares) Hospital Universitario 12 de Octubre Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Arribas Ynsaurriaga","sequence":"additional","affiliation":[{"name":"Cardiology Department and CIBERCV (Centro de Investigaci\u00f3n Biom\u00e9dica en Red en Enfermedades Cardiovasculares) Hospital Universitario 12 de Octubre Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6640-4839","authenticated-orcid":false,"given":"Pilar","family":"Escribano\u2010Subias","sequence":"additional","affiliation":[{"name":"Pulmonary Hypertension Unit, Department of Cardiology. ERN\u2010LUNG (European Reference Network on Rare Respiratory Diseases). 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