Maternal and fetal outcomes of pancreatitis in pregnancy

Abstract

Objective: This study examined maternal and neonatal outcomes that are associated with pancreatitis in pregnancy, in particular preeclampsia.

Study design: We conducted a retrospective cohort study of all singleton nonanomalous pregnancies in California from 2005-2008 with an identification of all cases of pancreatitis. Outcomes of interest included preeclampsia, intrauterine fetal death, preterm delivery, and neonatal or infant death. Univariate and multivariable analyses were then conducted to examine the association of pancreatitis in pregnancy and maternal characteristics and fetal outcomes.

Results: Our cohort of 2,039,870 pregnant women included 342 women (0.017%) with pancreatitis. Pancreatitis in pregnancy was not associated significantly with neonatal or infant death. When assessing fetal outcomes, pancreatitis was associated with preterm delivery, small for gestational age, jaundice, respiratory distress syndrome, and intrauterine fetal death (P < .001). Of note, pregnancy-associated pancreatitis was found to be associated with preeclampsia and severe preeclampsia in both univariate (P < .001) and multivariate analysis after we controlled for potential confounders (odds ratio, 4.21 [95% confidence interval, 2.99-5.93]; odds ratio, 7.85 [95% confidence interval, 5.03-12.24], respectively).

Conclusion: We found that pancreatitis in pregnancy was associated with several adverse maternal outcomes; in particular, a strong association existed with preeclampsia, which has its own implications and complications surrounding pregnancy management. Pancreatitis in pregnancy was also associated with increased risk for preterm delivery but not neonatal or infant death, which is consistent with the literature.

Keywords: hypertensive disorders; pancreatitis; preeclampsia; pregnancy; preterm delivery.