A Retrospective Cohort Study of Maternal and Fetal Outcomes in Pregnancies Complicated by Acute Pancreatitis [02N

Abstract

INTRODUCTION: Acute pancreatitis is a rare condition that can be associated with significant complications. In pregnancy, pancreatitis can be linked with poor maternal and fetal outcomes. The objective of this study is to better understand the complications associated with acute pancreatitis (AP) in pregnancy. METHODS: A retrospective cohort study using the Healthcare Cost and Utilization Project – National Inpatient Sample from the United States was performed. All pregnant women admitted with AP were identified using International Classification of Disease-9 coding from 1999 to 2015. The maternal and neonatal outcomes among women diagnosed with AP in pregnancy were compared to women without acute pancreatitis who delivered using multivariate logistic regression adjusting for baseline maternal characteristics. RESULTS: There were 14,258 admissions for AP in pregnancy among 13,815,919 births in our study period for an overall incidence of 10.3 cases per 10,000 births. Women admitted with AP in pregnancy were more likely to require transfusions, OR 2.58 (95% CI 2.32–2.87), develop pre-eclampsia, 3.81 (3.33–4.36), deliver prematurely, 4.27 (3.83–4.77), develop venous thromboembolisms, 3.97 (3.30–4.78), develop acute respiratory failure, 21.99 (19.08–25.34), develop disseminated intravascular coagulation, 7.66 (5.48–10.69), and to suffer from maternal death, 9.15 (6.05–13.85) as compared to women without AP. Acute pancreatitis in pregnancy was also associated with an increased risk of intrauterine fetal demise, 2.60 (1.86–3.62). CONCLUSION: Acute pancreatitis in pregnancy is associated with severe maternal and newborn complications and thus should be managed in tertiary level centers capable of providing with adequate maternal care for this condition as well and appropriate fetal and premature neonatal care.