CARDIOVASCULAR JOURNAL OF AFRICA • Volume 34, No 5, November/December 2023 290 AFRICA in which the birth characteristics were analysed. Overall, there were 12.8 and 30.2% of growth-restricted and low-birthweight babies, respectively, in our cohort. The severity of PH was proportional to the number of growth-restricted neonates, with the majority occurring in women with severe PH (p = 0.036). Similarly, as the severity of PH increased, the proportion of low-birthweight (< 2 500 g) babies born to these mothers increased (p < 0.001), again with the most low-birthweight babies born to women in the severe PH category. This was also the finding in the ROPAC study.7 This could be explained by the fact that the group of women with severe PH also had the highest proportion of preterm deliveries, hence the higher proportion of low-birthweight babies. This study is strengthened by the size of the cohort, which is large compared to previous studies on the subject. Also, all women were managed at a single centre with a uniform management protocol and all echocardiograms were performed by a single operator. One limitation is that our study was retrospective. Also, our cohort included only women who were managed at statesubsidised facilities and referred to IALCH, hence it does not represent the entire population of pregnant women with PH in KZN, who may be managed at private healthcare institutions, or those who may have died prior to referral to IALCH. Our follow-up period of six weeks postpartum may have limited the outcome findings as there may have been delayed outcomes beyond six weeks postpartum that our study cannot report on. Conclusion Traditionally, pregnancy has been contra-indicated in women with PH. 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