Rhinologic Conditions of Pregnancy: A Retrospective Cohort Study

Abstract

Objective: To better understand the prevalence, risk factors, and management strategies of pregnancy-related rhinologic conditions.

Study design: Retrospective cohort study from January 2013 to January 2023.

Setting: Tertiary level Otolaryngology-Head and Neck Surgery clinic.

Methods: Pregnant patients with rhinologic concerns were included. Data were collected on various parameters including age during pregnancy, gestational age at evaluation for rhinologic complication, obstetric history, history of pregnancy loss, primigravida status, rhinologic condition, aspirin usage during pregnancy, and presence of advanced maternal age (AMA, ≥35 years old). Stata/SE 17.0 Software was used for statistical analysis. A P-value of <.05 was considered significant.

Results: Fifty-seven pregnant patients were included. Patients presented with epistaxis (N = 25, 43.9%), chronic rhinosinusitis exacerbations (N = 22, 38.6%), and rhinitis of pregnancy (N = 10, 17.5%). Mean age at presentation was 34.7 years (22-53). Multivariate analysis revealed associations between epistaxis and primigravida status (P = .008) and rhinitis of pregnancy with a history of pregnancy loss (P = .012). Gestational diabetes mellitus was significantly associated with epistaxis on univariate analysis (P = .011).

Conclusion: There is a need for increased awareness among health care providers, including otolaryngologists, regarding the diagnosis and management of rhinologic conditions of pregnancy.

Keywords: advanced maternal age (AMA); chronic rhinosinusitis; epistaxis; otolaryngology; primigravida; rhinitis of pregnancy; rhinologic conditions of pregnancy.

Figure 1

Endoscopic view of a pyogenic granuloma in a patient with epistaxis of pregnancy. The lesion appears as a well‐defined, vascular mass on the nasal septum. Four patients in this study had a pyogenic granuloma.

Figure 2

Endoscopic view showing septal inflammation in a patient with rhinitis of pregnancy. The nasal septum appears swollen and erythematous, consistent with inflammatory changes.