Clinical Features, Predictive Markers and Maternal Fetal Outcomes in an Analysis of Acute Pancreatitis in Pregnancy: A Retrospective Multicenter Study

Background: Acute pancreatitis in pregnancy (APIP) is a rare but life-threatening complication for both mother and fetus. The purpose of this study was to describe the etiology, clinical indices, early predictive markers and maternal fetal outcomes of APIP.Methods: We retrospectively reviewed 52 APIP cases treated at the 5 tertiary care centers from January 2017 to December 2021 in Guangdong, China. We analyzed the etiology, vital signs, laboratory indices, predictive markers and long-term outcomes of APIP.Results: The most common causes of APIP were hypertriglyceridemia (36.5%) and biliary disease (26.9%). Heart rate (HR), white blood cell count, the percentage of blood neutrophils, serum glucose and triglycerides were correlated with the severity of APIP. The ability of HR to predict severe acute pancreatitis (SAP) was highest. There were no maternal deaths reported. The overall fetal mortality rate was 7.7% and 62.5% experienced neonatal asphyxia in SAP. Apgar scores among newborns of mild acute pancreatitis (MAP) were not different.Conclusions: The most frequent cause of APIP has changed and hypertriglyceridemia was the most common cause of APIP. The initial HR recorded after admission might be the new predictor of SAP. The severity of APIP was associated with higher risk of neonatal asphyxia. For MAP patients, conservative treatment was also desirable.