Key result
Pregnancy-associated diagnoses are not linked to in-hospital mortality among women on VA-ECMO.
Why the study?
Data regarding the use of venoarterial extracorporeal membrane oxygenation (VA-ECMO) in pregnancy are limited, necessitating evaluation of clinical characteristics and mortality predictors in this population.
Does the presence of a pregnancy-associated diagnosis affect in-hospital mortality in female patients requiring VA-ECMO?
Cross-Sectional (n=2,010)
Yes
Does the presence of a pregnancy-associated diagnosis affect in-hospital mortality in female patients requiring VA-ECMO?
Odds Ratio: 0.51 (95% CI 0.21–1.25)
Absolute Event Rate: 27.5% vs 40.2%
p-value: p=0.14
VA-ECMO is a feasible mechanical circulatory support strategy in female patients with pregnancy-associated diagnoses, demonstrating similar in-hospital mortality compared to non-pregnant female patients.
Null association on VA-ECMO should not alter management; leaves open whether pregnancy diagnoses confer survival benefit seen in prior observational data.
Background Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is used in patients with cardiopulmonary collapse, but data regarding its use in pregnancy is limited. We aimed to identify the clinical characteristics and predictors of in-hospital mortality in female patients requiring VA-ECMO, including evaluating the role of pregnancy. Methods In this cross-sectional study, a cohort of female patients aged 19-45 years who required VA-ECMO were identified from the National Inpatient Sample from 2018-2021 and further stratified according to presence of pregnancy-associated diagnoses. Baseline characteristics were compared using Pearson chi-square test and Wilcoxon rank-sum test for categorical and continuous variables, respectively. Multivariate analysis using a logistic regression model was performed to identify predictors of in-hospital mortality in the entire cohort. Subgroup analyses were done in patients with coronavirus disease 2019 (COVID-19). Results Of 2,010 female patients requiring VA-ECMO, 255 (12.7%) had a pregnancy-associated diagnosis. Cardiogenic shock was more common among patients without a pregnancy-associated diagnosis. There was no difference in in-hospital mortality between the two groups ( p =0.15). Infectious complications (adjusted odds ratio [OR]: 1.72 [1.01-2.93], p =0.05) were positively associated with in-hospital mortality. Pregnancy-associated diagnoses were not associated with survival (OR: 0.51 [0.21-1.25], p =0.14) in the entire cohort or in a subgroup of patients with COVID-19 (OR: 0.30 [0.01-19.01], p =0.52). Conclusions VA-ECMO remains a feasible option in patients with pregnancy-associated diagnoses requiring mechanical circulatory support. Infection control is required to decrease the associated in-hospital mortality.
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Parikh et al. (2025) conducted a cross-sectional in Cardiopulmonary collapse requiring mechanical circulatory support (n=2,010). Pregnancy-associated diagnosis vs. No pregnancy-associated diagnosis was evaluated on In-hospital mortality (OR 0.51, 95% CI 0.21-1.25, p=0.14). Pregnancy-associated diagnoses were not significantly associated with in-hospital mortality among female patients requiring VA-ECMO (OR 0.51, 95% CI 0.21-1.25, p=0.14).
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