Possible association between symptomatic cholelithiasis-complicated cholecystitis in pregnant women and congenital abnormalities in their offspring—A population-based case–control study

Abstract 

Objective

To estimate the risk of congenital abnormalities in the offspring of pregnant women with symptomatic cholelithiasis and complicated cholecystitis.

Study design

Comparison of the occurrence of medically recorded symptomatic cholelithiasis and complicated cholecystitis occurred any time of pregnancy (particularly in the second and/or third gestational month) of pregnant women who had malformed foetuses/newborns (cases) and who delivered healthy babies (controls) in the population-based Hungarian Case–Control Surveillance System of Congenital Abnormalities.

Results

Of 22,843 cases with CA, 62 (0.27%) had mothers with symptomatic cholelithiasis, while 119 (0.31%) mothers of 38,151 controls were recorded with symptomatic cholelithiasis. In addition, the mothers of 109 cases (0.48%) were affected by complicated cholecystitis during pregnancy compared with 145 controls (0.38%). Regarding the frequency, these two biliary diseases did not show any significant differences in the maternal variables, therefore case mothers were combined. The analysis of specific groups of congenital abnormalities showed an association between symptomatic cholelithiasis-complicated cholecystitis in the second and/or third gestation months, and neural tube defects (adjusted OR with 95% CI: 4.1, 1.3–13.4).

Conclusion

A higher rate of neural tube defects was found in the offspring of mothers with severe diseases of the biliary system during pregnancy. This finding needs to be confirmed by further studies and/or explanations to determine whether it is causal or a chance event.

Keywords: Cholecystitis, Cholelithiasis, Pregnancy, Maternal effect, Related drug treatment, Congenital abnormalities, Neural tube defects, Case–control study