Gestational Outcomes and Time to Subsequent Pregnancy After Acute Pancreatitis: A Nationwide Cohort Study.

BACKGROUND AND AIMS: Pancreatitis during reproductive years in women can have important implications for future gestational outcomes. However, data on reproductive health after acute interstitial pancreatitis (AIP) and necrotizing pancreatitis (NP) remain limited in this population. This study assesses time to subsequent pregnancy and pregnancy complications in a large Norwegian cohort.

METHODS

We conducted a population-based cohort study using linked data from the Norwegian Medical Birth Registry and Patient Registry (2008-2023), including 552,125 births. Women were categorized as controls or those with prior AIP or NP. We characterized the interval from pancreatitis diagnosis to subsequent pregnancy as a descriptive measure and assessed assisted reproductive technology utilization. Primary analytic outcomes were gestational diabetes mellitus, gestational hypertension, preterm birth, and cesarean delivery. Multivariable logistic regression adjusted for maternal age, body mass index, smoking, and comorbidity.

RESULTS

Women with prior pancreatitis had higher rates of obesity, smoking, and comorbidity. Median time from pancreatitis diagnosis to subsequent pregnancy was 18 months (AIP) and 22 months (NP). Rates of gestational diabetes mellitus, gestational hypertension, preterm birth, and cesarean delivery were significantly higher in both pancreatitis groups compared with controls (all P < .001). These associations remained significant after adjustment.

CONCLUSION

A history of pancreatitis is associated with modestly increased risks of adverse gestational outcomes. The observed interval from diagnosis to subsequent pregnancy likely reflects multiple clinical and behavioral factors and should not be interpreted as a direct measure of fertility. These findings provide population-level, hypothesis-generating data to inform future prospective studies.