Sokou Rozeta, Lianou Alexandra, Lampridou Maria, Panagiotounakou Polytimi, Kafalidis Georgios, Paliatsiou Styliani, Volaki Paraskevi, Tsantes Andreas G, Boutsikou Theodora, Iliodromiti Zoi, Iacovidou Nicoletta
Neonatal Department, National and Kapodistrian University of Athens, Aretaieio Hospital, 11528 Athens, Greece.
Neonatal Intensive Care Unit, "Agios Panteleimon" General Hospital of Nikea, 18454 Piraeus, Greece.
Medicina (Kaunas). 2025 Jun 11;61(6):1077. doi: 10.3390/medicina61061077.
High-risk pregnancies (HRPs) constitute a significant global health issue due to their strong association with increased maternal and neonatal morbidity and mortality. Although pregnancy is generally characterized by positive expectations, the presence of maternal comorbidities, gestational complications, or adverse socioeconomic and environmental conditions can markedly elevate the probability of unfavorable outcomes. HRPs contribute disproportionately to complications such as preterm birth, fetal growth restriction, low birth weight, and congenital anomalies, which are key determinants of neonatal mortality and long-term developmental and health challenges. A broad spectrum of risk factors as well as insufficient prenatal care, underscores the complex nature of HRPs. These conditions necessitate a multidisciplinary management approach encompassing early risk identification, continuous monitoring, and individualized interventions. The neonatal prognosis in such contexts is strongly influenced by gestational age at delivery, birth weight, the standard of neonatal care, and the underlying etiological factors driving preterm or complicated deliveries. Preventive strategies including comprehensive prenatal screening, systematic antenatal follow-up, and timely referral to specialized perinatal care centers are essential for reducing the burden of HRPs. Furthermore, addressing social determinants of health-such as low socioeconomic status and limited access to healthcare-is critical for optimizing maternal and neonatal outcomes. This review consolidates current evidence on the epidemiology, etiological factors, and clinical implications of high-risk pregnancies, emphasizing the necessity of an integrative, preventive, and multidisciplinary framework to mitigate adverse neonatal outcomes and improve long-term health trajectories.
高危妊娠（HRPs）是一个重大的全球健康问题，因为它们与孕产妇和新生儿发病率及死亡率的增加密切相关。尽管怀孕通常伴随着积极的期望，但孕产妇合并症、妊娠并发症或不利的社会经济和环境状况的存在会显著提高不良结局的可能性。高危妊娠对早产、胎儿生长受限、低出生体重和先天性异常等并发症的影响尤为突出，这些并发症是新生儿死亡率以及长期发育和健康挑战的关键决定因素。广泛的风险因素以及产前护理不足，凸显了高危妊娠的复杂性。这些情况需要采取多学科管理方法，包括早期风险识别、持续监测和个性化干预。在这种情况下，新生儿的预后受到分娩时的孕周、出生体重、新生儿护理标准以及导致早产或复杂分娩的潜在病因的强烈影响。包括全面产前筛查、系统的产前随访以及及时转诊至专业围产期护理中心在内的预防策略对于减轻高危妊娠的负担至关重要。此外，解决健康的社会决定因素，如社会经济地位低下和获得医疗保健的机会有限，对于优化孕产妇和新生儿结局至关重要。本综述整合了关于高危妊娠的流行病学、病因因素和临床影响的现有证据，强调了建立一个综合、预防和多学科框架以减轻不良新生儿结局并改善长期健康轨迹的必要性。
