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Acute Pancreatitis in Pregnancy: A Propensity Score Matching Analysis and Dynamic Nomogram for Risk Assessment

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Abstract

Background

Acute pancreatitis is easily confused with abdominal pain symptoms, and it could lead to serious complications for pregnant women and fetus, the mortality was as high as 3.3% and 11.6–18.7%, respectively. However, there is still lack of sensitive laboratory markers for early diagnosis of APIP and authoritative guidelines to guide treatment.

Objective

The purpose of this study was to explore the risk factors of acute pancreatitis in pregnancy, establish, and evaluate the dynamic prediction model of risk factors in acute pancreatitis in pregnancy patients.

Study Design

Clinical data of APIP patients and non-pregnant acute pancreases patients who underwent regular antenatal check-ups during the same period were collected. The dataset after propensity matching was randomly divided into training set and verification set at a ratio of 7:3. The model was constructed using Logistic regression, least absolute shrinkage and selection operator regression, R language and other methods. The training set model was used to construct the diagnostic nomogram model and the validation set was used to validate the model. Finally, the accuracy and clinical practicability of the model were evaluated.

Results

A total of 111 APIP were included. In all APIP patients, hyperlipidemic pancreatitis was the most important reason. The levels of serum amylase, creatinine, albumin, triglyceride, high-density lipoprotein cholesterol, and apolipoprotein A1 were significantly different between the two groups. The propensity matching method was used to match pregnant pancreatitis patients and pregnant non-pancreatic patients 1:1 according to age and gestational age, and the matching tolerance was 0.02. The multivariate logistic regression analysis of training set showed that diabetes, triglyceride, Body Mass Index, white blood cell, and C-reactive protein were identified and entered the dynamic nomogram. The area under the ROC curve of the training set was 0.942 and in validation set was 0.842. The calibration curve showed good predictive in training set, and the calibration performance in the validation set was acceptable. The calibration curve showed the consistency between the nomogram model and the actual probability.

Conclusion

The dynamic nomogram model we constructed to predict the risk factors of acute pancreatitis in pregnancy has high accuracy, discrimination, and clinical practicability.

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Funding

Nature Science Foundation of Sichuan Province (No. 2022NSFSC1378).

Author information

Author notes

  1. Xiaowei Tang and Yuan Chen have contributed equally to this study.

Authors and Affiliations

  1. Department of Gastroenterology, the Affiliated Hospital of Southwest Medical University, Street Taiping No.25, Region Jiangyang, Luzhou, 646099, Sichuan, China

    Xiaowei Tang, Yuan Chen, Jiao Jiang, Bei Luo, Wensen Ren, Xueqin Zhou, Xiaomin Shi, Wei Zhang, Lei Shi, Xiaolin Zhong & Muhan Lü

  2. Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China

    Xiaowei Tang, Yuan Chen, Jiao Jiang, Bei Luo, Wensen Ren, Xueqin Zhou, Xiaomin Shi, Wei Zhang, Lei Shi, Xiaolin Zhong & Muhan Lü

  3. Department of Gastroenterology, Lianshui County People’ Hospital, Huaian, China

    Shu Huang

  4. Department of Gastroenterology, Lianshui People’ Hospital of Kangda College Affiliated to Nanjing Medical University, Huaian, China

    Shu Huang

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  1. Xiaowei Tang
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Contributions

Study conception and design: Xiaowei Tang, Yuan Chen, and Shu Huang. Drafting of manuscript: Yuan Chen, Jiao Jiang, Bei Luo, Wensen Ren, and Xueqin Zhou. Acquisition of data and critical revision: Xiaomin Shi, Wei Zhang, Lei Shi, and Xiaolin Zhong. Revision of manuscript and final approval of manuscript: Muhan Lü.

Corresponding author

Correspondence to Muhan Lü.

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Competing interests

The authors declare no competing interests.

Ethical approval and consent to participate

This study was granted ethical approval by the Ethics Committee of Affiliated Hospital of Southwest Medical University. The need for written informed consent was waived by the Ethics Committee of Affiliated Hospital of Southwest Medical University due to the retrospective nature of the study. Administrative permissions were required to access and use medical records from the corresponding author and were granted by the data protection officers of the hospital. All methods were performed in accordance with relevant guidelines and regulations.

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Tang, X., Chen, Y., Huang, S. et al. Acute Pancreatitis in Pregnancy: A Propensity Score Matching Analysis and Dynamic Nomogram for Risk Assessment. Dig Dis Sci (2024). https://doi.org/10.1007/s10620-024-08415-8

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