Clinical characteristics and early identification of acute pancreatitis in pregnancy with risk for organ failure: a retrospective study

Background: Acute pancreatitis in pregnancy (APIP) with organ failure (OF) is a rare but serious disease. Here, we describe the primary characteristics associated with APIP, and explore potential predictors for early recognition of OF among the patients. Methods: : A total of 3154 patients with AP from January 2018 to December 2021 were retrospectively reviewed. After screening, we enrolled 49 patients with APIP and 184 non-pregnant AP patients. Clinical characteristics and blood biochemical information were assessed using IBM SPSS 26.0 software and the rms package in R. Results: : The most primary cause of APIP was hypertriglyceridemia (59.2%), while respiratory failure (46.9%) was the main type in all OF patients. Age, hemoglobin (Hb), hematocrit (HCT), aminotransferase (ALT), creatinine (Cr), blood urea nitrogen (BUN), albumin (ALB) and sodium ion (Na + ) in the pregnant group were lower than in the non-pregnant group (P<0.05), while body mass index (BMI), triglyceride (TG) and total cholesterol (TC) in the pregnant group were higher (P<0.05). Among the APIP patients, BUN, TG and TC were independent risk factors for predicting OF, (P < 0.05) and they were used to create a nomogram with accurate prediction performance. (AUC=0.941) Conclusions: : APIP was highly correlated with hypertriglyceridemia and respiratory failure. Higher BMI was a distinguishing feature of OF-APIP patients. The data indicate that close monitoring of BUN, TG and TC levels is essential for early prevention of OF in APIP patients.