Pancreatitis in Pregnancy

OBJECTIVE: To estimate the incidence, cause, and complications of pancreatitis in pregnancy and to identify factors associated with adverse outcomes. METHODS: This study was a chart review of all pregnant patients diagnosed with pancreatitis from 1992-2001 at 15 participating hospitals. Information was collected on presentation, management, and outcome, along with the number of deliveries at each hospital. RESULTS: During the 10 years of the study, 101 cases of pancreatitis occurred among 305,101 deliveries, yielding an incidence of one in 3,021 (.03%). There were no maternal deaths; perinatal mortality was 3.6%. Eighty-nine women had acute pancreatitis, and 12 women had chronic pancreatitis. The majority (66%) of cases of acute pancreatitis were biliary in origin, and they were associated with better outcomes than nonbiliary causes. Cases of gallstone pancreatitis that received surgical or endoscopic intervention during pregnancy had lower rates of preterm delivery and recurrence than those that were conservatively managed, but this difference was not significant (P=.2). Alcohol was responsible for 12.3% of acute pancreatitis cases and 58% of chronic pancreatitis cases and was associated with increased rates of recurrence and preterm delivery. A calcium level, triglycerides, or both was not obtained in half of cases identified as idiopathic. CONCLUSION: Pancreatitis is a rare event in pregnancy, occurring in approximately 3 in 10,000 pregnancies. Although it is most often acute and related to gallstones, nonbiliary causes should be sought because they are associated with worse outcomes.