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Risk of acute appendicitis in and around pregnancy: a population-based cohort study from England

Zingone, Fabiana; Sultan, Alyshah Abdul; Humes, David; West, Joe

Authors

Fabiana Zingone

Alyshah Abdul Sultan

DAVID HUMES david.humes@nottingham.ac.uk
Clinical Associate Professor

JOE WEST JOE.WEST@NOTTINGHAM.AC.UK
Professor of Epidemiology



Abstract

Objective: To determine the absolute and relative risk of acute appendicitis during the antepartum and postpartum periods compared with the time outside pregnancy among women of childbearing age.

Background: Acute appendicitis is the most common nonobstetric surgical emergency during pregnancy. Estimates of the incidence of acute appendicitis in pregnancy remain imprecise and inconsistent.

Methods: All potential fertile women aged 15 to 44 years registered within Clinical Practice Research Datalink with linkages to the Hospital Episodes Statistics between 1997 and 2012 were identified. Absolute rates of acute appendicitis were calculated during the antepartum and postpartum periods and were compared with the time outside pregnancy in terms of incidence rate ratio (IRR) using a Poisson regression model.

Results: Among 1,624,804 women, there were 362,219 pregnancies resulting in live or stillbirths. Compared with the time outside pregnancy, the rate of acute appendicitis was 35% lower during the antepartum period [IRR, 0.65; 95% confidence interval (CI), 0.55–0.76], with the lowest rate reported during the third trimester (IRR, 0.47; 95% CI, 0.35–0.64) for all ages; no increased risk of acute appendicitis was observed in the postpartum period compared with the time outside pregnancy among women aged 15 to 34 years but an 84% increased risk for women older than 35 years (IRR, 1.84; 95% CI, 1.18–2.86). The highest and lowest rates of negative appendectomy were encountered in the second and the third trimesters, respectively.

Conclusions: Pregnant women are less likely to be diagnosed with acute appendicitis than nonpregnant women, with the lowest risk reported during the third trimester.

Journal Article Type Article
Publication Date Feb 1, 2015
Journal Annals of Surgery
Print ISSN 0003-4932
Electronic ISSN 1528-1140
Publisher Lippincott, Williams & Wilkins
Peer Reviewed Peer Reviewed
Volume 261
Issue 2
APA6 Citation Zingone, F., Sultan, A. A., Humes, D., & West, J. (2015). Risk of acute appendicitis in and around pregnancy: a population-based cohort study from England. Annals of Surgery, 261(2), https://doi.org/10.1097/sla.0000000000000780
DOI https://doi.org/10.1097/sla.0000000000000780
Keywords acute appendicitis, antepartum, incidence, postpartum pregnancy
Publisher URL http://journals.lww.com/annalsofsurgery/Fulltext/2015/02000/Risk_of_Acute_Appendicitis_in_and_Around.19.aspx
Copyright Statement Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by-nc-nd/4.0

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Copyright Statement
Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by-nc-nd/4.0





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