Pregnancy-associated extracorporeal life support: insights from a nationwide dual-cohort analysis
Authors' conclusion
Pregnancy-associated ECLS is rare but is increasing in incidence, and identifies a clinically high-risk population with substantial early maternal and neonatal risk.
Study context
- Population
- Pregnant or peripartum patients requiring extracorporeal life support (ECLS), linked Taiwanese databases, 2001–22dual cohorts
- Participants
- 247 / 3,970,948 / 247 / 2,112
- Exposure
- Pregnancy-associated ECLS vs non-ECLS pregnancies; pregnancy-associated ECLS vs non-pregnant women of reproductive age receiving ECLS
- ECLS pregnanciesn = 247
- Non-ECLS pregnanciesn = 3,970,948reference
- Pregnancy-associated ECLSn = 247
- Non-pregnant ECLSn = 2,112reference
- Outcome
- Incidence of pregnancy-associated ECLS and 42-day maternal mortality
Methodological detailsnationwide, dual-cohort, linked databases
- Nationwide
- Dual-cohort
- Linked databases
Main finding
As reported in the abstract
Incidence of pregnancy-associated ECLS per 100 000 deliveries, increasing over time (P trend <0.001)
6.2
Maternal mortality at 42 days
41.3%
Observational data: associations, not effects.
Further findings
All-cause mortality beyond 42 days postpartum
| aHR (95% CI) | ||
|---|---|---|
| ECLS-exposed pregnant patients | 28.0 (16.8–46.8) | |
| 0.050.21520Adjusted hazard ratio (log scale) |
| Outcome | aHR (95% CI) | |
|---|---|---|
| Long-term survival, ECLS cohortPregnancy-associated ECLS vs Non-pregnant ECLS | 0.42 (0.23–0.78) | |
| 0.20.5125Adjusted hazard ratio (log scale) |
| Outcome | Pregnancy-associated ECLS | Non-pregnant ECLS |
|---|---|---|
| In-hospital mortality, ECLS cohort | 43.7% | 53.8% |
Leading indications for pregnancy-associated ECLS
- Amniotic fluid embolism
- 26.7%
- Peripartum cardiomyopathy
- 18.6%
- Respiratory failure
- 12.6%
- Highest mortality in obstetric indications
Neonatal outcomes
- Higher risks of preterm birth, low birth weight and major morbidity
All-cause mortality beyond 42 days postpartum
- Also higher CV mortality, permanent dialysis and psychiatric disorders
Safety
Maternal morbidities · 42 days
- Renal failure
- 36.4%
- Major bleeding
- 11.3%
- Stroke
- 10.9%
Original publication
Pregnancy-associated extracorporeal life support: insights from a nationwide dual-cohort analysis. Br J Anaesth. Published 20 August 2026. doi:10.
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