P0049 - Pregnancy and Neonatal Outcomes in Chronic Pancreatitis: A Population-Based Study

Sunday, October 22, 2023

3:30 PM – 7:00 PM PT

Location: Exhibit Hall

Presenting Author(s)

Khaled Alsabbagh Alchirazi, MD

Cleveland Clinic
Cleveland, OH

Khaled Alsabbagh Alchirazi, MD¹, AbdelKader Chaar, MD², Motasem Alkhayyat, MD¹, Thabet Qapaja, MD¹, Muaz Alsabbagh, MD¹, Sushrut Trakroo, MD³, Prabhleen Chahal, MD⁴
¹Cleveland Clinic, Cleveland, OH; ²Yale University School of Medicine, New Haven, CT; ³Cleveland Clinic, Strongsville, OH; ⁴Cleveland Clinic Foundation, Cleveland, OH

Introduction: Chronic pancreatitis (CP) is characterized by a chronic inflammatory state associated with recurrent painful episodes. Very limited data are available on the relationship between CP and pregnancy. This study aims to evaluate the risk of adverse pregnancy outcomes in women with a history of CP.

Methods: We conducted a 5-year retrospective analysis using the National Inpatient Sample (NIS 2016-2020) of all adult female pregnant patients who had delivery-related discharge diagnoses. We used multivariate logistic regression to compare maternal and fetal outcomes among those with a history of chronic pancreatitis versus those without chronic pancreatitis after adjusting for possible confounders. Discharge weights were applied to provide national estimates.

Results: Of the 19,122,560 deliveries in the database, there were 3,305 births in women with CP. Baseline characteristics and demographics are listed in Table 1. Length of stay was higher in pregnant women with CP (3 days vs 2 days, p < 0.001) compared to pregnant women without CP, table 1. Pregnant women with CP were at higher risk for several pregnancy, obstetrics, and neonatal adverse outcomes. Pregnant women with CP were more likely to have hypertensive diseases including preeclampsia (OR 1.6 [1.28-2.01]), eclampsia (OR 5.91 [2.78-12.59]) and hemolysis elevated liver enzyme low platelet syndrome (HELLP) (OR 6.79 [4.13-11.16]) when compared to pregnant women without CP. Pregnant women with CP were at higher risk of placenta abruption (OR 2.05 [1.27-3.40]) but no difference in placenta previa when compared with pregnant women without CP. Pregnant women with CP were at higher risk of hysterectomy (OR 7.79 [3.73-16.26]). When compared to pregnant women without CP, pregnant women with CP were at higher risk of preterm birth (OR 1.88 [1.44-2.46]) and small for gestational age/poor fetal growth (OR 1.98 [1.49-2.64]), Figure 1.

Discussion: In our study, we found that pregnant women with CP were at increased risk of maternal, obstetrics and neonatal complications. Further studies are needed to investigate the underlying mechanisms behind these associations and improve outcomes for both mothers and babies.

Figure: Figure1 : The impact of of chronic pancreatitis on maternal (Panel A), obstetric (Panel B) and neonatal (Panel C) outcomes. Abbreviations: HTN: hypertension; DM; diabetes mellitus; OR: Odds ratio; CI: confidence interval.

	No CP n=19,119,255 (%)	CP n=3,305 (%)	p-value
Age (years), mean ± SD	29.12 ± 5.7	30.18 ± 5.7	< 0.001
Race			< 0.001
White	52.16	56.19
Black	15.68	21.22
Hispanic	20.71	16.50
Asian or Pacific Islander	6.14	2.55
Native American	0.75	0.79
Other	4.56	2.75
Median household income, %			< 0.001
0-25th percentile	28.15	38.15
26th to 50th percentile	25.42	26.29
51st to 75th percentile	24.61	20.21
76th to 100th percentile	21.83	15.35
Primary Payer, %			< 0.001
Medicare	0.77	6.21
Medicaid	42.54	60.15
Private insurance	51.28	27.88
Self-pay	2.60	2.12
No charge	0.07	0.00
Other	2.74	3.64
Region of hospital, %			< 0.001
Northeast	16.00	11.80
Midwest	20.94	29.35
South	39.30	40.09
West	23.76	18.76
Teaching status, %			< 0.001
Rural	8.84	5.45
Urban non-teaching	19.93	10.44
Urban teaching	71.23	84.11
Length of stay (days), median [IQR]	2 [2-3]	3 [2-5]	< 0.001
Total hospital charges ($), median [IQR]	17,916 [11,918 – 27,438]	23,676 [14,671 – 41,591]	< 0.001

Table: Table 1: Baseline demographics of women who delivered between 2016 and 2020, by chronic pancreatitis disease status.

Disclosures:

Khaled Alsabbagh Alchirazi indicated no relevant financial relationships.

AbdelKader Chaar indicated no relevant financial relationships.

Motasem Alkhayyat indicated no relevant financial relationships.

Thabet Qapaja indicated no relevant financial relationships.

Muaz Alsabbagh indicated no relevant financial relationships.

Sushrut Trakroo indicated no relevant financial relationships.

Prabhleen Chahal indicated no relevant financial relationships.

Khaled Alsabbagh Alchirazi, MD¹, AbdelKader Chaar, MD², Motasem Alkhayyat, MD¹, Thabet Qapaja, MD¹, Muaz Alsabbagh, MD¹, Sushrut Trakroo, MD³, Prabhleen Chahal, MD⁴. P0049 - Pregnancy and Neonatal Outcomes in Chronic Pancreatitis: A Population-Based Study, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.