Differences in Mortality Between Pregnant and Nonpregnant Women After Cardiopulmonary Resuscitation

Obstet Gynecol. 2016 Oct;128(4):880-888. doi: 10.1097/AOG.0000000000001629.


Objective: To examine the association between pregnancy status and in-hospital mortality after cardiopulmonary resuscitation (CPR) in an inpatient setting.

Methods: We conducted a population-based cross-sectional study using the Nationwide Inpatient Sample databases (2002-2011). International Classification of Diseases, 9th Revision, Clinical Modification codes were used to define cases, comorbidities, and clinical outcomes. Rates of CPR among study groups were calculated by patient and hospital characteristics. Survey logistic regression was used to estimate adjusted odds ratios (ORs) that represent the association between pregnancy status and mortality after CPR. Joinpoint regression was used to describe temporal trends in CPR and mortality rates.

Results: During the study period, 5,923 women (13-49 years) received inpatient CPR annually. Cardiopulmonary resuscitation rates increased significantly from 2002 to 2011, by 6.4% and 3.8% annually, for pregnant and nonpregnant women, respectively. In-hospital mortality rates after CPR were lower among pregnant women 49.4% (45.4-53.4) than nonpregnant women 71.1% (70.1-72.2), even after adjusting for confounders (adjusted OR 0.46, 95% confidence interval 0.39-0.56).

Conclusion: Cardiopulmonary resuscitation in an inpatient pregnant woman is associated with improved survival compared with this procedure in nonpregnant women. Elucidating reasons behind this association could help to improve CPR outcomes in both pregnant and nonpregnant women.

MeSH terms

  • Adolescent
  • Adult
  • Cardiopulmonary Resuscitation / statistics & numerical data*
  • Case-Control Studies
  • Cross-Sectional Studies
  • Emergency Service, Hospital / statistics & numerical data
  • Female
  • Humans
  • Inpatients*
  • Middle Aged
  • Outcome Assessment, Health Care*
  • Perinatal Care*
  • Pregnancy
  • Pregnancy Complications, Cardiovascular / epidemiology
  • Pregnancy Complications, Cardiovascular / mortality
  • Pregnancy Complications, Cardiovascular / therapy*
  • Survival Rate
  • United States / epidemiology
  • Young Adult