Acute Pancreatitis During and After Pregnancy: Incidence, Risk Factors, and Prognosis
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ORIGINAL ARTICLE
Acute Pancreatitis During and After Pregnancy: Incidence, Risk Factors, and Prognosis Alberto Maringhini1 · Gabriella Dardanoni2 · Giovanna Fantaci2 · Rosalia Patti1 · Marco Maringhini3 Received: 9 February 2020 / Accepted: 7 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Acute pancreatitis may complicate pregnancy and both are associated with gallstones, but its incidence is not well known. Aims To validate hospital discharge records in diagnosing acute pancreatitis and gallstones and to evaluate acute pancreatitis incidence in non pregnant, pregnant and after delivery using hospital discharge records Methods We identified all hospital discharge records of hospitalized Sicilian women of childbearing age (2011–2016). We determined agreement between 300 hospital discharge records and hospital records in diagnosing acute pancreatitis and gallstones. Acute pancreatitis incidence, prognosis, and their relationship with age and gallstones were calculated in the three groups using hospital discharge records. Results There was 92% and 88% agreement in diagnosing acute pancreatitis and gallstones between hospital discharge and hospital records. In non pregnant, 1,564 of 7,236,863 women-years (21.61/100,000 person-years) developed acute pancreatitis. During pregnancy, 34 of 226,492 women-years developed acute pancreatitis (20.02/100,000 person-years). Postpartum acute pancreatitis incidence was higher than non pregnant, only in the first 2 years with the peak in the first semester (95.4/100,000 person-years). The increased incidence of postpartum acute pancreatitis was associated with gallstones in youngest women (gallstones acute pancreatitis in women below 20 years old versus non pregnant: rate ratios 16.61; 95% CI 8.40–32.87). Conclusions Agreement in acute pancreatitis and gallstones diagnosis between hospital discharge and hospital records was accurate. Acute pancreatitis incidence was increased only in the first 2 years after delivery in young women with gallstones. Keywords Acute pancreatitis · Gallstone · Hospital discharge records · Pregnancy
* Alberto Maringhini [email protected]; [email protected] Gabriella Dardanoni [email protected] Giovanna Fantaci [email protected] Rosalia Patti [email protected] Marco Maringhini [email protected] 1
Dipartimento Medicina, ARNAS Ospedale Civico, Piazza Nicola Leotta 4, 90127 Palermo, Italy
2
Dipartimento per le Attività Sanitarie ed Osservatorio Epidemiologico, Regione Sicilia, Via Vaccaro, 5, 90145 Palermo, Italy
3
Dipartimento di Medicina Interna, Università di Palermo, Via del Vespro 129, 90127 Palermo, Italy
Abbreviations AP Acute pancreatitis GS Gallstones HDR Hospital discharge records P Pregnancy NP Non pregnancy RR Rate ratios
Introduction Acute pancreatitis (AP) may complicate pregnancy (P) [1, 2], and both are associated with gallstones (GS) and sludge [3–7]. GS are the most frequent
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