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.
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