In Response

Abstract

Sample database to identify pregnant patients who needed extracorporeal membrane oxygen (ECMO). The authors reported the indication for ECMO, prevalence of risk factors, and the association of peripartum outcomes with in-hospital mortality. 3 The leading indication for ECMO was respiratory failure, and the overall mortality rate was 30.5%. The majority of the patients who received ECMO were White (48.1%) and Black (32.7%). 3 Although Hispanics comprise 18.9% of the United States population, Hispanic (3.7%) parturients were disproportionately underrepresented in the study sample.It is established that pregnant and peripartum women with a diagnosis of COVID-19 have increased morbidity and need for ECMO support and mortality when compared to nonpregnant women with COVID-19. 4 In a retrospective study that compared survival of pregnant and peripartum with nonpregnant women with severe COVID-19, it was found that venovenous (VV) ECMO in this population was associated with increased survival when compared with a propensity-matched cohort of VV ECMO-supported nonpregnant women with COVID-19. 4 Moreover, this study found that pregnant and peripartum women supported on ECMO for COVID-19 were more likely to be Hispanic, Black, or Asian when compared to the nonpregnant cohort. 4 Furthermore, as highlighted above, Black and Hispanic pregnant women were disproportionately affected by COVID-19. 4 We applaud the authors' efforts in characterizing the use of vital resources, and we aim to highlight the importance of including demographic and socioeconomic data in our attempt to understand resource allocation and utilization. We agree that more work is needed in terms of investigating further patient characteristics with relation to predictors and hospital outcomes in pregnant patients undergoing ECMO. As highlighted above, it has long been established that there are extensive variations in maternal care based on racial and ethnic characteristics of patient populations. While this data is from 2010 to 2016, the COVID-19 pandemic highlighted the differences in outcomes among racial and ethnic groups. Therefore, it would be worthwhile to investigate more recent data and the impact of demographic and socioeconomic factors on ECMO outcomes, particularly in pregnancy.