Association of appendectomy for acute appendicitis in pregnancy with adverse obstetrical outcomes

Abstract

Abstract Background Acute appendicitis (AA) in pregnancy is associated with miscarriage and preterm birth. Even if undergoing appendectomy, pregnant women still have a risk of miscarriage or preterm birth. The aim of this study was to assess the risk factors associated with miscarriage and preterm birth, as well as the impact of these risk factors on gestational age at delivery among patients who had confirmed AA and received appendectomy. Methods A single-center retrospective case‒control study was performed. Clinical information was documented, and relationships between variables and outcomes were assessed by univariate and multivariate logistic or linear regression analyses reaching a significance of p value < 0.05. Results A total of 91 pregnant women were included and were divided into miscarriage or preterm birth (n = 31) and term birth (n = 60) groups. There were no significant differences in the demographic characteristics of the studied population. Anorexia was an independent risk factor that was associated with miscarriage or preterm birth (OR 9.80, 95% CI 1.70-56.34). The time from symptom onset to appendectomy among patients with miscarriage or preterm birth was significantly longer than that among patients with term birth (OR 1.03, 95% CI 1.00-1.06), and they had a significantly earlier gestational age at delivery, with a difference of 1.68 weeks. Conclusions Appendectomy should be performed as soon as possible for pregnant women with highly suspected or confirmed AA. Delayed appendectomy and prolonged time from symptom onset to appendectomy increase the risk of miscarriage or preterm birth. Anorexia was another independent risk factor for miscarriage or preterm birth, which should be given due attention. Trial registration Retrospectively registered.