Neonatal Outcomes Following Maternal Antepartum Extracorporeal Life Support

Area of Science:

• Perinatal Medicine
• Neonatal Intensive Care
• Critical Care Medicine

Background:

• Extracorporeal life support (ECLS) is established for maternal antepartum emergencies like respiratory failure or cardiogenic shock.
• High survival rates for mothers and fetuses during antepartum ECLS are documented.
• Limited data exists on the long-term outcomes of neonates exposed to antepartum ECLS.

Purpose of the Study:

• To evaluate the neonatal outcomes and neurodevelopmental follow-up of infants born to mothers treated with antepartum ECLS.
• To assess the incidence of comorbidities and developmental delays in this cohort.

Main Methods:

• Retrospective single-center study of adult antepartum ECLS cases from February 2015 to April 2023.
• Inclusion criteria focused on cases with available neonatal follow-up data.
• Data collected included maternal demographics, ECLS parameters, gestational age at delivery, neonatal comorbidities, and neurodevelopmental outcomes.

Main Results:

• Seven mother-neonate dyads met inclusion criteria.
• ECLS was primarily initiated for respiratory failure (86%) at a median gestational age of 27.0 weeks.
• All mothers and neonates survived to delivery and discharge; common comorbidities included prematurity (100%) and bronchopulmonary dysplasia (43%).
• At a median follow-up of 1.4 years, 57% underwent neurodevelopmental testing, with 50% showing speech/language delays.

Conclusions:

• Antepartum ECLS offers high survival rates for both mother and neonate.
• Neonates exposed to antepartum ECLS generally have good survival without significant morbidity.
• Neurodevelopmental follow-up, particularly for speech and language, is warranted for these children.