Preeclampsia and the Risk of Pancreatitis: A Nationwide, Population-Based Cohort Study

Abstract

Background. Preeclampsia is a multiple organ dysfunction during pregnancy, including hepatic, renal, and neurological dysfunction, and is defined as hypertension and proteinuria occurring after 20 weeks of pregnancy. Clinical features seen in preeclampsia are due to relatively poorly perfused placenta and maternal endothelial dysfunction. Some studies have found that preeclampsia may cause acute pancreatitis due to microvascular abnormalities and visceral ischemia. This retrospective cohort study used the Taiwanese National Health Insurance Research Databases (NHIRD) to study the relationship between preeclampsia and the risk of pancreatitis. Methods. In total, 606,538 pregnant women were selected from the NHIRD between January 1, 1998 and December 31, 2010. They were divided into a preeclampsia cohort ( $n=\mathrm{485,211}$ ) and a nonpreeclampsia cohort ( $n=\mathrm{121,327}$ ). After adjusting for comorbidities that may induce pancreatitis, we analyzed and compared the incidence of pancreatitis in the two cohorts. Results. The overall incidence of pancreatitis in the preeclampsia cohort was significantly higher than that in the control cohort (4.29 vs. 2.33 per 10,000 person-years). The adjusted HR of developing pancreatitis increased 1.68-fold (95% CI: 1.19-2.36) in the preeclampsia cohort. In addition, pregnant women with preeclampsia without comorbidities had a significantly high risk of pancreatitis ( $\text{aHR}=1.83$ , 95% CI 1.27-2.63). The combined effect of preeclampsia and alcohol-related diseases resulted in the highest risk of pancreatitis ( $\text{aHR}=43.4$ , 95% CI: 6.06-311.3). Conclusion. Compared with patients without preeclampsia, the risk of pancreatitis in patients with preeclampsia is significantly increased after adjusting for demographics and comorbidities. The risk of pancreatitis is greatly increased when preeclampsia is accompanied by alcohol-related diseases, hepatitis C, gallstones, diabetes, or age of 26–35 years. Early identification and effective control of preeclampsia and the associated comorbidities can reduce the risk of pancreatitis and the associated morbidity and mortality.