Primary hyperparathyroidism-induced acute pancreatitis in pregnancy: A systematic review with a diagnostic-treatment algorithm

Table 1 Comparison of the characteristics between the survived and deceased mothers due to maternal primary hyperparathyroidism-induced acute pancreatitis during pregnancy

Variables	Entire cohort, n = 54, 100.0%	Mother alive, n = 49, 90.7%	Mother died, n = 5, 9.3%	P value
Age in years	29 (26-32)	29 (27-32)	26 (24-33)	0.25
Previous pregnancies	2 (1-2)	2 (1-2)	2 (1-2)	0.56
Previous deliveries	1 (0-1)	1 (0-1)	1 (1-2)	0.35
Pancreatitis occurrence in gestational week	27 (20-33)	26 (20-33)	28 (21-40)	0.38
Pancreatitis postpartum	4 (7.4)	3 (6.1)	1 (20.0)	0.33
Surgical management	11 (20.4)	8 (16.3)	3 (60.0)	0.052
Amylase in IU/L	1399 (519-2072)	1415 (510-2006)	1200 (642-3091)	0.66
Lipase in IU/L	2072 (893-2804)	2072 (869-2521)	3320 (855-6997)	0.31
Calcium in mmol/L	3.5 (3.1-3.9)	3.5 (3.1-3.8)	3.1 (2.5-4.7)	0.73
Phosphorus in mmol/L	0.7 (0.7-0.7)	0.7 (0.7-0.7)	0.7 (0.7-0.8)	0.50
PTH in pg/mL	384 (123-910)	302 (122-910)	910 (541-5665)	0.059
Abortion	2 (3.7)	1 (2.0)	1 (20.0)	0.18
Complex delivery	7 (13.0)	6 (12.2)	1 (20.0)	0.52
Delivery occurrence week	36 (36-38)	36 (36-39)	36 (23-37)	0.09
Fetal/child death	5 (9.3)	4 (8.2)	1 (20.0)	0.40

Data are n (%) or median (Q1-Q3). PHT: Parathormone.

Table 2 Comparison of the characteristics between the group of fetal/child survival or death due to maternal primary hyperparathyroidism-induced acute pancreatitis during pregnancy

Variables	Entire cohort, n = 54, 100.0%	Child alive, n = 49, 90.7%	Fetal/child death, n = 5, 9.3%	P value
Age in years	29 (26-32)	29 (26-32)	28 (28-36)	0.77
Previous pregnancies	2 (1-2)	2 (1-2)	2 (1-7)	0.98
Previous deliveries	1 (0-1)	1 (0-1)	1 (1-5)	0.52
Pancreatitis occurrence week	27 (20-33)	28 (22-33)	16 (13-26)	0.08
Pancreatitis post-partum	4 (7.4)	4 (8.2)	0 (-)	1.00
Surgical management	11 (20.4)	10 (20.4)	1 (20.0)	0.73
Amylase in IU/L	1399 (519-2072)	1500 (510-2072)	1113 (752-2004)	0.89
Lipase in IU/L	2072 (893-2804)	2072 (869-2808)	1415 (751-5664)	0.95
Calcium in mmol/L	3.5 (3.1-3.9)	3.3 (3.1-3.8)	4.1 (3.8-4.7)	0.009
Phosphorus in mmol/L	0.7 (0.7-0.7)	0.7 (0.7-0.7)	0.7 (0.5-0.8)	0.89
PTH in pg/mL	384 (123-910)	302 (122-910)	1914 (910-3330)	0.003
Abortion	2 (3.7)	0 (-)	2 (40.0)	0.007
Complex delivery	7 (13.0)	4 (8.2)	3 (60.0)	0.01
Delivery week	36 (36-38)	36 (36-39)	34 (19-39)	0.12
Mother death	5 (9.3)	4 (8.2)	1 (20.0)	0.40

Data are n (%) or median (Q1-Q3). PHT: Parathormone.

Table 3 Multivariable models for the identification of the risk factors for maternal or fetal mortality during pregnancy and postpartum

Variables	Beta	SE	Wald	OR	Lower	Upper	P value
Mother death
Lipase in IU/L	0.001	< 0.001	4.63	1.001	1.00	1.001	0.03
Delivery week	-0.21	0.10	4.46	0.81	0.66	0.99	0.04
Previous pregnancies	-2.61	1.34	3.80	0.07	0.01	1.01	0.051
Previous deliveries	3.22	1.65	3.80	25.12	0.98	64.68	0.051
Constant	4.15	3.29	1.59	63.37	-	-	0.21
Fetal/child death
Complex delivery	5.25	2.31	5.18	11.31	2.07	17.67	0.02
Pancreatitis occurrence in pregnancy week	-0.25	0.13	3.84	0.78	0.61	1.00	0.05
Constant	1.32	1.81	0.53	3.73	-	-	0.47

Variables initially introduced in the model’s construction: Patient age, previous pregnancies, previous deliveries, pregnancy week in which the pancreatitis was diagnosed, serum calcium, serum phosphorous, parathormone, amylase, lipase, surgical management of acute pancreatitis, aborted fetus, complex delivery, delivery week. OR: Odds ratio.