Author(s)
Yasmin Eltawil, BS
Jacquelyn Callander, MD
Patricia Loftus, MD
Affiliation(s)
University of California San Francisco;
Abstract:
Introduction:
Rhinologic complications of pregnancy are common. Hormonal effects on the nasal mucosa are likely contributors. Despite its prevalence, the literature surrounding the topic remains sparse. The objective of this study is to characterize rhinologic complaints during pregnancy that prompt otolaryngologist referral and evaluation.
Methods: A retrospective cohort study was performed, assessing all pregnant patients evaluated in the otolaryngology clinic of a tertiary care center from January 2013- January 2023. Subjects with a rhinologic concern were included in the analysis and electronic medical records were mined for data.
Results:
The study included sixty pregnant patients with rhinologic concerns. Chief complaints included epistaxis (43.9%), rhinitis of pregnancy (17.5%), and exacerbation of chronic rhinosinusitis (38.6%). Within the subgroup of patients with epistaxis, twenty (80%) were primigravida, and this risk factor was positively correlated with epistaxis on multivariate analysis controlling for advanced maternal age, gestational diabetes, pre-eclampsia, gestational and chronic hypertension (p=0.043). Though exacerbation of chronic rhinosinusitis was a common etiology for presentation, this was not associated with any of the aforementioned potential risk factors.
Conclusion:
Epistaxis was the primary reason for referral to an otolaryngologist, and primigravida status was identified as a novel risk factor for this complication. Many patients also presented in the setting of exacerbation of chronic rhinosinusitis. Improved understanding of the prevalence and risk factors for pregnancy-related rhinologic concerns will allow us to better counsel and ultimately treat this vulnerable patient population.