Predicting fetal loss in severe acute pancreatitis during pregnancy: a 5-year single-tertiary-center retrospective analysis

Yang, Zhenyu; Guo, Guangyang; Li, Hui

doi:10.1080/00325481.2020.1752010

Cited by 22 publications

(22 citation statements)

References 24 publications

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“…As reported in our previous research, the mean gestation week for the fetal death group was 32.7 ± 4.7 weeks, while the fetal survival group was 36.4 ± 2.2 weeks ( 25 ). Other studies also reported that earlier gestation week was related to higher fetal mortality ( 4 , 17 , 26 ). For example, Tang et al reported that six patients suffered fetal deaths in the first or second trimester ( 4 ), and Xu et al reported that five patients had fetal deaths in the first or second trimester ( 13 ).…”

Section: Discussionmentioning

confidence: 82%

“…Second, as one of the largest acute pancreatitis transfer centers in China, the majority of patients were diagnosed with SAP (47.78%) and HTG-APIP (64.4%). Tang et al and Yang et al report that HTG is a risk factor for fetal death in APIP ( 8 , 26 ). Compared with other etiologies, HTG-APIP was more prevalent in severe AP cases, with more complications, and poorer prognosis ( 7 , 13 , 16 , 17 ).…”

Section: Discussionmentioning

confidence: 99%

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Risk Factors for Fetal Death and Maternal AP Severity in Acute Pancreatitis in Pregnancy

Shi

et al. 2021

Front. Pediatr.

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Background: Acute pancreatitis in pregnancy is a rare but highly life-threatening gestational and perinatal disease.Objective: This study aimed to identify the risk factors for fetal death and acute pancreatitis severity.Methods: This retrospective cohort study enrolled patients with acute pancreatitis in pregnancy in our center from January 1, 2012, to August 1, 2020, and classified them according to two clinical endpoints, fetal outcome and disease severity. The groups were examined and compared according to gestational week, etiology, gravidity and parity, complications in pre- and post-delivery, and medical history. Logistic regression analysis was performed to identify the independent risk factors for fetal death and acute pancreatitis severity.Results: Of the 90 enrolled patients, 28 (31.1%) had fetal death and 43 (47.8%) had severe acute pancreatitis. Logistic regression analysis showed that pre-delivery acute respiratory distress syndrome (OR, 5.8; 95% CI, 1.5–22.4; p = 0.010) and gestational week (OR, 0.9; 95% CI, 0.8–1.0; p = 0.011) were risk factors for fetal death. Gestation week (OR, 1.2; 95% CI, 1.1–1.3; p = 0.003) and fetal intrauterine death (OR, 5.9; 95% CI, 1.8–19.4; p = 0.003) were risk factors for severe acute pancreatitis.Conclusions: Pre-delivery acute respiratory distress syndrome and gestational week were independent risk factors for fetal death. Fetal intrauterine death and gestational week were independent risk factors for severe acute pancreatitis.

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Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Risk Factors for Fetal Death and Maternal AP Severity in Acute Pancreatitis in Pregnancy

Shi

et al. 2021

Front. Pediatr.

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“…In this nested case-control study, AMA women with fetal loss at 14 weeks of gestation or later were enrolled as the case group; fetal loss included induced labor due to fetal abnormality, spontaneous or artificial abortion, and stillbirth [9]. The fetal abnormalities included congenital abnormalities and chromosomal abnormalities, such as anencephalus, single atrium, single ventricle, gastroschisis, thanatophoric dwarfism, trisomies, and monosomy X [11].…”

Section: Subjectsmentioning

confidence: 99%

“…AMA has been associated with adverse pregnancy outcomes, including spontaneous abortion, fetal chromosomal and congenital abnormalities, spontaneous late preterm delivery, and stillbirth [6][7][8]. Abortion, stillbirth, or induced labor can lead to fetal loss [9]. Some studies have shown that the risk of adverse perinatal outcomes is elevated with increasing maternal age [10].…”

Section: Introductionmentioning

confidence: 99%

Analysis of the causes and influencing factors of fetal loss in advanced maternal age: a nested case-control study

Wang

Lin

Liu

et al. 2021

BMC Pregnancy Childbirth

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Background The risk of fetal loss is higher among ≥35-year-olds than younger women. The present study aimed to explore the causes and factors influencing fetal loss in advanced maternal age (AMA). Methods AMA women with singleton fetuses (< 14 gestational weeks) who underwent their first prenatal examination in the Obstetrics Department of Fujian Maternity and Child Health Hospital from December 2018 to June 2020 were included in this cohort study. Those who terminated the pregnancy before 14 gestational weeks were excluded. A baseline survey was conducted, and follow-up was carried out until the termination of the pregnancy. Clinical data were extracted to analyse the causes of fetal loss among them. In the nested case-control study, the AMA women with fetal loss were enrolled as the case group, and women without fetal loss in the same period were enrolled as the control group, in a 1:2 ratio matched by age and gestational weeks. Logistic regression models were used to analyse the factors influencing fetal loss. Results A total of 239 women with fetal loss and 478 controls were enrolled. The causes of fetal loss were most often fetal factors, followed by maternal factors, umbilical cord factors, and placental factors. Multivariate logistic regression analysis indicated that junior high school education and below (adjusted odds ratio (aOR) = 5.13, 95% confidence interval (CI): 2.19–12.02), senior high school education (aOR = 4.91, 95% CI: 2.09–11.54), residence in a rural area (aOR = 2.85, 95% CI: 1.92–4.25), unemployment (aOR = 1.81, 95% CI: 1.20–2.71), spontaneous abortion history (aOR = 1.88, 95% CI: 1.26–2.80), preterm birth history (aOR = 11.08, 95% CI: 2.90–42.26), hypertensive disorders of pregnancy (aOR = 7.20, 95% CI: 2.24–23.12), and preterm premature rupture of membranes (aOR = 4.12, 95% CI: 1.53–11.11) were risk factors for fetal loss. Conclusions Low educational level, unemployment, abnormal pregnancy/labor history, and pregnancy complications were correlated with the incidence of fetal loss in AMA. Thus, early identification as well as a targeted intervention, should be conducted.

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“…SAP in pregnancy (SAPIP) is hazardous to the health of pregnant women, andthe maternal mortality rate can be as high as about 20-40% [1,6]. The fetus of SAPIP is even prone to intrauterine distress and death [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Nomogram for Predicting Persistent Organ Failure with Acute Pancreatitis in Pregnancy

Sheng

Wang

2022

Preprint

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Background: Acute pancreatitis in pregnancy (APIP) with persistent organ failure (POF) poses a high risk of death for mother and fetus. This study sought to create a nomogram model for early prediction of POF with APIP patients.Methods: We conducted a cross-sectional study on APIP patients with organ failure (OF) between January 2012 and March 2021 in a university hospital. 131 patients were collected. Their clinical courses and pregnancy outcomes were obtained. Risk factors for POF were identified by univariate and multivariate logistic regression analysis. Prediction models with POF were built and nomogram was plotted. The performance of the nomogram was evaluated by using a bootstrapped-concordance index and calibration plots.Results: Hypertriglyceridemia was the most common etiology in this group of APIP patients, which accounted for 50% of transient organ failure (TOF) and 72.3% of POF. All in-hospital maternal death was in the POF group (P<0.05), which also had a significantly higher perinatal mortality rate than the TOF group (P<0.05). Univariate and multivariate logistic regression analysis determined that lactate dehydrogenase, triglycerides, serum creatinine, and procalcitonin were independent risk factors for predicting POF in APIP. A nomogram for POF was created by using the four indicators. The area under the curve was 0.875 (95% confidence interval 0.80–0.95). The nomogram had a bootstrapped-concordance index of 0.85 and was well-calibrated.Conclusions: Hypertriglyceridemia was the leading cause of organ failure-related APIP. Lactate dehydrogenase, triglycerides, serum creatinine, and procalcitonin were the independent risk factors of POF in APIP. Our nomogram model showed an effective prediction of POF with the four indicators in APIP patients.

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Predicting fetal loss in severe acute pancreatitis during pregnancy: a 5-year single-tertiary-center retrospective analysis

Cited by 22 publications

References 24 publications

Risk Factors for Fetal Death and Maternal AP Severity in Acute Pancreatitis in Pregnancy

Risk Factors for Fetal Death and Maternal AP Severity in Acute Pancreatitis in Pregnancy

Analysis of the causes and influencing factors of fetal loss in advanced maternal age: a nested case-control study

Nomogram for Predicting Persistent Organ Failure with Acute Pancreatitis in Pregnancy

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