Clinical Course of Chronic Pancreatitis During Pregnancy and its Effect on Maternal and Fetal Outcomes

Abstract

Introduction: There are limited data on the effect of chronic pancreatitis (CP) on pregnancy outcomes and vice versa. Our aim was to evaluate the clinical trajectory of CP during pregnancy and its effect on pregnancy outcomes. Methods: All female patients of child-bearing age (≥15 years) diagnosed with CP were studied from January 2004 to July 2019. The change in frequency of painful episodes was assessed before, during, and after pregnancy. Maternal and fetal outcomes were compared between pregnant women (early onset) and women presenting with CP after completion of all pregnancies (late onset). Results: Of 187 women with CP, pregnancy outcomes and clinical course were assessed in 99 patients. The frequency of painful exacerbations was significantly lower during pregnancy compared with prepregnancy and postpregnancy periods (P < 0.001). The median pain score decreased significantly to 0 (0–2) during pregnancy from 3 (0–6) before conception and increased to 4 (0–8) after pregnancy (P = 0.002). Women with early onset CP (n = 57) had their first child later and had fewer pregnancies compared with those with late onset CP (n = 42). There was no difference in maternal outcomes such as gestational diabetes, hypertension, and preterm delivery, and fetal outcomes such as abortion, low birth weight, and still birth between the groups. There was no reported congenital anomaly. DISCUSSION: Younger patients with CP had later and fewer pregnancies, but there was no increased risk of adverse maternal and fetal outcomes. The clinical course of CP was usually benign during pregnancy with decreased frequency and severity of pain.

Epidural Analgesia for Pain Management in Acute Pancreatitis during Pregnancy and Its Effect on Maternal and Fetal Outcome

“…This shows that the maternal and fetal outcomes were comparable in all three groups. One of the authors has published an article on maternal and fetal outcomes in pancreatitis and reported no increased risk of maternal and fetal outcomes [ 21 ].…”

Pancreatitis in Pregnancy—Comprehensive Review

“…Hence, it is so important to care for a pregnant woman in such a way that (thanks to early diagnosis), it is possible to prevent the development of acute pancreatitis, and if the disease develops, it could be properly treated. Children born to mothers diagnosed with hypertriglyceridemia during pregnancy have impaired lipid homeostasis and are more prone to atherosclerosis [ 38 ].…”

“…This is still the case outside reference centers. Hence, the main cause of CP in pregnant women is alcohol abuse, and the second is idiopathic CP, but it should be assumed that, in both of these groups, mutations predisposing to CP can be found in the majority of women [ 38 ].…”

Chronic Pancreatitis in Females is Not Associated With Adverse Pregnancy Outcomes

“…8 Another study of 57 patients with CP reported no increased risk of adverse maternal and fetal outcomes and had benign clinical course of CP during pregnancy. 9 The motherhood is a most important and desirable lifetime event for females. However, in cases of patients suffering from chronic gastrointestinal disorders, the course of pregnancy and postnatal period may get complicated resulting in adverse pregnancy outcomes.…”

“…Eddy et al reported 11 patients of CP in a cohort of 101 patients with pancreatitis with limited information on clinical outcomes in patients with CP 8. Another study of 57 patients with CP reported no increased risk of adverse maternal and fetal outcomes and had benign clinical course of CP during pregnancy 9…”