Comparison of Clinical and Serum Metabolomic Profiles between High-Altitude Tibetan and Low-Altitude Han Pregnant Women

Objective Long-term high-altitude residents exhibit unique adaptations to hypoxia. This study explored metabolic mechanisms underlying such adaptations in pregnant Tibetan women.Methods Tibetan pregnant women residing at high altitudes in Tibet and Han pregnant women living at low altitudes in Jingzhou were recruited, along with their newborns. Basic demographic and clinical data were systematically collected, and non-targeted metabolomic profiling was performed on maternal peripheral serum to compare metabolic characteristics between the two groups.Results A total of 30 Tibetan and 28 Han healthy mother–infant pairs were included in the study. Clinical data showed that, compared with Han mothers, Tibetan mothers had a younger maternal age at delivery, higher systolic blood pressure, and elevated ALT and AST levels (P < 0.05), as well as lower WBC count, MCV, and serum total protein levels (P < 0.05). Serum metabolomics analysis identified 288 differential metabolites, among which 201 were upregulated in Tibetan mothers, predominantly lipids and lipid-like molecules, including bile acids, cholesterol derivatives, steroids, and glycerophosphocholines. KEGG pathway enrichment analysis (after FDR correction) revealed 13 significantly enriched pathways (FDR < 0.1), such as caffeine metabolism, steroid hormone biosynthesis, and bile secretion.Conclusion Tibetan mother–infant pairs adapt to high-altitude hypoxia via metabolic and hormonal regulation, supporting placental function and fetal energy homeostasis. These findings provide systematic insight into high-altitude metabolic adaptation and may inform pregnancy management.