Chronic Pancreatitis in Females is Not Associated With Adverse Pregnancy Outcomes

Abstract

Background: The effects of chronic pancreatitis (CP) on pregnancy and vice versa have not been studied well. We aimed to study the impact of CP on pregnancy-related outcomes and the effect of pregnancy on clinical profile of CP. Study and Goals: We did a retrospective analysis of all female patients of CP of child-bearing age (above 18 y). The pregnancy-related outcomes of patients with CP were compared with the age-matched 115 controls from the low-risk pregnancy group identified using a simplified antepartum high-risk pregnancy scoring form. The clinical course of CP during pregnancy was compared with the pre-pregnancy course. Results: Among the 338 eligible patients, 46 patients were included after exclusions. All these 46 patients had at least 1 conception and 41 had at least 1 completed pregnancy with a total of 117 conceptions and 96 completed pregnancies. The pregnancy-related outcomes in patients with CP like abortions (21.7% vs. 11.3%; P=0.087), preterm deliveries (14.6% vs. 10.4%; P=0.47), antepartum course (82.7% vs. 82.6%; P=0.58), stillbirths (4.9% vs. 4.3%; P=0.88), cesarean section (36.6% vs. 34%; P=0.849) were comparable with controls. There was overall improvement in the severity and frequency of pain during pregnancy as compared with the pre-pregnancy symptoms (P=0.001). Conclusion: CP is not associated with adverse pregnancy outcomes. Also, there is trend toward improvement in the clinical symptoms because of CP during the pregnancy.

Pancreatitis in Pregnancy—Comprehensive Review

“…There were no significant differences in the course of pregnancy in both groups with regard to gestational diabetes, arterial hypertension, or premature delivery. There was also no evidence of an increased number of miscarriages, low birth weight, or birth defects [ 39 , 40 ].…”

“…A special form of CP is autoimmune pancreatitis (ACP); in doubtful cases (especially in the presence of jaundice), diagnostics should be extended to include the determination of IgG4, antinuclear antibodies (ANAs), and against carbonic anhydrase. The diagnosis of ACP fundamentally changes the management, and the rapid initiation of steroid therapy, which is not contraindicated in pregnancy, may contribute to rapid clinical improvement [ 40 ]. Complications that may occur in the course of CP require a careful, individual approach, taking into account the guidelines recommended in such cases in CP without pregnancy.…”