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妊娠期急性胰腺炎母婴结局的一项基于人群的研究。

Maternal and fetal outcomes of acute pancreatitis in pregnancy: a population-based study.

机构信息

Internal medicine residency program, Rochester General Hospital, Rochester, New, USA.

Harbin Medical University, Harbin, China.

出版信息

Eur J Gastroenterol Hepatol. 2023 Dec 1;35(12):1354-1361. doi: 10.1097/MEG.0000000000002665. Epub 2023 Oct 17.

Abstract

BACKGROUND

Acute pancreatitis during pregnancy can have negative effects on both the mother and the fetus. The primary aim of this study is to evaluate the trends, maternal and fetal outcomes, and associated comorbidities of acute pancreatitis during pregnancy using data from the USA National Inpatient Sample (NIS) database.

METHODS

This study is a retrospective analysis of hospital discharge records from the NIS database from 2009 to 2019.

RESULTS

Delivery patients with acute pancreatitis faced a higher risk of maternal mortality (AOR 91.02, 95% CI 28.47-291.06), postpartum hemorrhage (AOR 1.59, 95% CI 1.02-2.49), and hypertensive complications (defined as preeclampsia, eclampsia, or HELLP syndrome) (AOR 3.42, 95% CI 2.56-4.56) compared to those without acute pancreatitis. Moreover, we saw an increased incidence of preterm labor (AOR 3.94, 95% CI 3.02-5.12) and fetal death (AOR 3.12, 95% CI 1.76-5.53). Rates of fetal restriction and large fetal size were comparable. Additionally, the acute pancreatitis group showed higher rates of acute kidney injury (4.2% vs. 0.06%; AOR, 31.02, 95% CI 12.50-76.98), severe sepsis (0.8% vs. 0.01%; AOR, 34.49, 95% CI 7.67-155.14), and respiratory failure (2.4% vs. 0.06%; AOR, 20.77, 95% CI (8.55-50.41). There were no significant differences in maternal and perinatal outcomes in biliary pancreatitis after the intervention compared to conservative treatment.

CONCLUSION

Acute pancreatitis during pregnancy can have negative effects on both the mother and fetus. Treatment for biliary pancreatitis does not affect maternal and fetal outcomes. An interdisciplinary approach is essential to ensure optimal outcomes for mothers and their offspring in these cases.

摘要

背景

妊娠期胰腺炎可对母婴均产生负面影响。本研究旨在利用美国国家住院患者样本(NIS)数据库的数据,评估妊娠期胰腺炎的趋势、母婴结局和相关合并症。

方法

这是一项对 NIS 数据库 2009 年至 2019 年住院记录的回顾性分析。

结果

患有急性胰腺炎的分娩患者发生母亲死亡(OR 91.02,95%CI 28.47-291.06)、产后出血(OR 1.59,95%CI 1.02-2.49)和高血压并发症(定义为子痫前期、子痫或 HELLP 综合征)(OR 3.42,95%CI 2.56-4.56)的风险高于无急性胰腺炎的患者。此外,我们发现早产(OR 3.94,95%CI 3.02-5.12)和胎儿死亡(OR 3.12,95%CI 1.76-5.53)的发生率增加。胎儿生长受限和巨大儿的发生率相似。此外,急性胰腺炎组的急性肾损伤发生率较高(4.2% vs. 0.06%;OR 31.02,95%CI 12.50-76.98)、严重脓毒症(0.8% vs. 0.01%;OR 34.49,95%CI 7.67-155.14)和呼吸衰竭(2.4% vs. 0.06%;OR 20.77,95%CI 8.55-50.41)。与保守治疗相比,经介入治疗后胆源性胰腺炎对母婴结局无显著影响。

结论

妊娠期胰腺炎可对母婴均产生负面影响。胆源性胰腺炎的治疗并不影响母婴结局。对于这些病例,需要采取多学科方法,以确保母婴获得最佳结局。

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