ArticlePhilosophical transactions of the Royal Society of London. Series B, Biological sciences2025
Altitude and risk of pre-eclampsia: insights from a large-scale epidemiological study in Ecuador.
Article in Philosophical transactions of the Royal Society of London. Series B, Biological sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
4 citing papers in PubMed.
- Oxidative dyslipidemia in early pregnancy: integrating atherogenic index of plasma (AIP) and uric acid (UA) to refine preeclampsia risk stratification.Frontiers in pharmacology · 2026Article
- Pregnancy at high altitude: evolutionary and historical perspectives.Philosophical transactions of the Royal Society of London. Series B, Biological sciences · 2025Review
- Pregnancy at high altitude: the challenge of hypoxia.Philosophical transactions of the Royal Society of London. Series B, Biological sciences · 2025Article
- Altitude and risk of pre-eclampsia: insights from a large-scale epidemiological study in Ecuador.Philosophical transactions of the Royal Society of London. Series B, Biological sciences · 2025Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
Exposure to hypobaric hypoxia at high altitude is associated with adverse pregnancy outcomes, including low birth weight and stillbirth. However, the relationship between high altitude and pre-eclampsia remains less well defined, with conflicting findings in previous studies. Improved understanding of pre-eclampsia risk at altitude could help in targeting resources, particularly in low-resourced settings. This study aimed to evaluate the impact of altitude, analysed as a continuous nonlinear variable, on the risk of pre-eclampsia in Ecuador. Publicly available maternal health records from Ecuador (2021-23) were obtained from the National Institute of Statistics and Census. Geospatial techniques were used to assign the altitude of maternal residence, and generalized additive models determined the relationship between altitude and pre-eclampsia incidence, adjusting for maternal age, ethnicity, healthcare access, and residence. Models were fitted using restricted maximum likelihood. After adjusting for confounders, no significant increase in pre-eclampsia risk was observed with higher altitude. However, as expected, increased risk was noted at the extremes of maternal age (
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