Outcomes of Extracorporeal Membrane Oxygenation in Pregnant vs. Non-Pregnant Women with Cardiogenic Shock: A Nationwide Analysis

Introduction: Cardiovascular disease is the leading cause of pregnancy-related mortality in the U.S., with rise in heart failure and cardiogenic shock. The use of Extracorporeal Membrane Oxygenation (ECMO) in cardiogenic shock is increasing, however, data on its use in pregnancy remain limited. This study aimed to assess the utilization and outcomes of ECMO in pregnant and postpartum women admitted to the hospital with cardiogenic shock.Methods: We conducted a nationwide retrospective study using the National Inpatient Sample (2016–2021) to evaluate ECMO utilization and outcomes in pregnant and postpartum women with cardiogenic shock. Demographic characteristics, hospital charges, complications, and clinical outcomes were compared in two groups of study population.Results: Among 44,940 women of reproductive age with cardiogenic shock, 3,640 (8.1%) received ECMO, including 145 pregnant/postpartum women. Pregnant/postpartum women were younger (31.2 vs. 36.3 years, p<0.001), had fewer cardiovascular comorbidities, and had lower mortality rates (17.2% vs. 37.05%, p=0.03). Hospital charges were lower ($661,143 vs. $955,654, p<0.001). Complication rates, including venous thromboembolism, pulmonary embolism, major bleeding, stroke, need for mechanical ventilation, and renal replacement therapy, were similar between groups.Conclusion: ECMO remains a life-saving intervention for pregnant women with cardiogenic shock, demonstrating comparable outcomes to non-pregnant women.