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妊娠期胰腺炎的母婴结局

Maternal and fetal outcomes of pancreatitis in pregnancy.

作者信息

Hacker Francis M, Whalen Phoebe S, Lee Vanessa R, Caughey Aaron B

机构信息

Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR.

Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR.

出版信息

Am J Obstet Gynecol. 2015 Oct;213(4):568.e1-5. doi: 10.1016/j.ajog.2015.07.031. Epub 2015 Jul 26.

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.

摘要

目的

本研究探讨了与妊娠期胰腺炎相关的孕产妇和新生儿结局,尤其是子痫前期。

研究设计

我们对2005年至2008年加利福尼亚州所有单胎非畸形妊娠进行了一项回顾性队列研究,识别出所有胰腺炎病例。感兴趣的结局包括子痫前期、胎儿宫内死亡、早产以及新生儿或婴儿死亡。然后进行单因素和多因素分析,以研究妊娠期胰腺炎与孕产妇特征及胎儿结局之间的关联。

结果

我们的队列包括2,039,870名孕妇,其中342名(0.017%)患有胰腺炎。妊娠期胰腺炎与新生儿或婴儿死亡无显著关联。在评估胎儿结局时,胰腺炎与早产、小于胎龄儿、黄疸、呼吸窘迫综合征及胎儿宫内死亡相关(P <.001)。值得注意的是,在控制潜在混杂因素后,单因素(P <.001)和多因素分析均发现妊娠相关性胰腺炎与子痫前期和重度子痫前期相关(优势比分别为4.21 [95%置信区间,2.99 - 5.93];优势比为7.85 [95%置信区间,5.03 - 12.24])。

结论

我们发现妊娠期胰腺炎与多种不良孕产妇结局相关;特别是与子痫前期存在强关联,这对子痫前期的妊娠管理有其自身的影响和并发症。妊娠期胰腺炎还与早产风险增加相关,但与新生儿或婴儿死亡无关,这与文献一致。

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