Title : Breastfeeding in prevention of postpartum Acute Pancreatitis (AP). A Sicilian population-based case-control study
Abstract:
Background
Gallstones acute pancreatitis has increased incidence in young women in the 2 years postpartum. Middle aged women with longer period of breastfeeding have less hospitalization for gallbladder disease.
Methods
We identified all sicilian women who delivered (2013-2016) and had acute pancreatitis within 2 years postpartum, reviewed their medical records and for each case we matched 4 women of the same age (+ 5 years), date (+ 30 days) and hospital of delivery without acute pancreatitis. Univariate and multivariate logistic regression was used to estimate the Odds Ratio (OR) to assess associations between acute pancreatitis and clinical variables.
Results
In the 74 women with AP and 298 controls at univariate analysis: > 6 months oral contraception history (p<0.01 - OR 3.30 - 95% CI 1.33-8.16); previous biliary disease (p < 0.001 - OR 5.90 - 95% CI 1.98-17.57) and smoking (p = 0.035 - OR 2.04 - 95% CI 1.04-4.0) were predictors of acute pancreatitis; amenorrhea > 3 months (p < 0.001 - OR 0.34 - 95% CI 0.19-0.59) and breastfeeding > 3 months (p < 0.001 - OR 0.07 - 95% CI 0.03-0.14) were protective. At multivariate previous biliary disease (p = 0.011 - OR 5.49 - 95% CI 1.48-20.38) was predictor and breastfeeding >3 months (p < 0.001- OR 0.06 CI 95% 0.03-0.14) was protective for acute pancreatitis.
Conclusions
Women without a history of biliary disorders and who breastfeed for at least 3 months have reduced risk to develop AP in the 2 years after delivery.
Audience Take away:
1. Biliary sludge and gallstones develop during pregnancy but only in the first 2 years after delivery we observed a strong increase of incidence of acute pancreatitis mainly in youg women below 35 years old with gallstones pancreatitis. Women who breastfeed at least 3 months have significat reduction of incidence of acute pancreatitis.
2. The ormonal background during pregnancy and after delivery are strong related tpo this phenomenon, future research has to highlight the subpopulation at risk to develop acute pancretitis to screen gallbladder disease and to treat with bile acids.
3. Medical education to inform women to the importance of breastfeeding in prevention of acute pancreatitis and the other well known conditions breastfeedin protect.
