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Pregnancy Rhinitis

What Is It, Treatment, and More

Author: Ali Syed, PharmD

Editors: Ahaana Singh, Ian Mannarino, MD, MBA

Illustrator: Jillian Dunbar

Copyeditor: Joy Mapes


What is pregnancy rhinitis?

Pregnancy rhinitis refers to an inflammation of the mucous membranes, the tissues lining the nasal passages, in pregnant individuals. It typically lasts for 6 or more weeks without any clear cause.

What causes pregnancy rhinitis?

The exact cause of pregnancy rhinitis remains unknown. However, research suggests that the increase in blood volume that occurs due to pregnancy may be a contributing factor. Fluctuations in hormones -- such as estrogen, progesterone, placental growth hormone, and human growth hormone -- may also play a role, as they can lead to inflammation and swelling of the nasal mucous membranes. Inflamed mucous membranes may result in increased blood flow to the nasal passages and consequent enlargement of the nasal veins, leading to nasal congestion.

Other potential risk factors for pregnancy rhinitis may include smoking or having chronic rhinitis (i.e., long-lasting stuffy nose) before pregnancy. Pregnancy rhinitis is typically diagnosed by a medical professional after ruling out other causes of nasal congestion or irritation, such as allergies, viral or bacterial infections, or any other respiratory disorders during pregnancy.

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When does pregnancy rhinitis start?

Although pregnancy rhinitis may start at any time during pregnancy, it most commonly affects pregnant individuals in the first trimester, or first three months of pregnancy, and again in late pregnancy.

What are the signs and symptoms of pregnancy rhinitis?

Signs and symptoms of pregnancy rhinitis characteristically include a stuffy nose, due to increased mucus and pressure in the nasal passages. Other symptoms during pregnancy may include excess mucus dripping down the back of the throat (i.e., post-nasal drip), runny nose, increased ear pressure, sneezing, reduced sense of smell, and disturbed sleep.

Complications of pregnancy rhinitis may include ear infections, sinus infections, or, for individuals with asthma, the worsening of asthma symptoms. If individuals experience any complications, it is recommended that they seek professional medical assessment. 

How is pregnancy rhinitis treated?

Treatment of pregnancy rhinitis aims to relieve symptoms as much as possible and improve quality of life. Treatment options may include avoiding certain allergens or irritants -- possibly pollen, animal dander, dust mites, smoke, or strong odors -- which may contribute to the condition or make symptoms worse.

Other treatments may include using medication-free, salt water nasal sprays (i.e., saline sprays) or a sterilized neti pot with sterile saline solution to rinse allergens, debris, and mucus out of the nasal passages, which may help relieve nasal congestion and facilitate breathing. Elevating the head of the bed and using dilating nasal strips while sleeping may also be considered.

Depending on the severity of an individual’s symptoms, certain medications may be recommended under the direction of a medical professional. Safe medication options during pregnancy and breastfeeding may include the use of first-generation antihistamines, like chlorpheniramine, or second-generation antihistamines, like cetirizine, to help dry up mucus. To prevent potential adverse effects to the fetus’ central nervous system, the use of first-generation antihistamines is not recommended near the end of pregnancy.
If non-medicated options or antihistamines are inadequate for symptom relief, oral decongestants, such as pseudoephedrine, may be considered. Oral decongestants are considered safe to use during pregnancy. However, it is recommended pregnant individuals do not take oral decongestants during the first trimester due to a small risk of birth defects.
Medicated nasal sprays (e.g., intranasal sodium cromoglycate) may help relieve nasal congestion and are considered safe and well-tolerated during pregnancy and breastfeeding. Due to limited data regarding effects during pregnancy and breastfeeding, steroidal nasal sprays, such as inhaled fluticasone, are usually reserved for symptoms unresponsive to antihistamines, decongestants, and intranasal sodium cromoglycate. Nasal decongestants, like xylometazoline, may be considered for use after the first trimester, but there is limited evidence for their use during pregnancy.

Therapeutic alternatives may be considered under the direction of a medical professional on a case-by-case basis if necessary. 

How long does pregnancy rhinitis last?

Pregnancy rhinitis may come and go during pregnancy. Often, symptoms last for six weeks or more. The good news is that symptoms typically disappear within two weeks after delivery. 

What are the most important facts to know about pregnancy rhinitis?

Pregnancy rhinitis refers to an inflammation of the tissues lining the nasal passages in pregnant individuals. Although pregnancy rhinitis may occur at any time during pregnancy, it typically presents in the beginning of pregnancy, at the end, or at both stages. Symptoms of pregnancy rhinitis may last for 6 weeks, with complete resolution of symptoms within 2 weeks after delivery. The exact cause of pregnancy rhinitis remains unclear; however, factors may include increased blood flow, hormonal fluctuations, and other risk factors, such as pre-existing rhinitis or smoking. Signs and symptoms of pregnancy rhinitis often include a stuffy or runny nose, sneezing, post-nasal drip, and increased ear pressure. Complications of pregnancy rhinitis may involve infections and worsening of preexisting asthma. Treatment of pregnancy rhinitis can include avoiding allergens and irritants, using non-medicated saline sprays, and, under the direction of a medical professional, taking specific medication that is safe for use during pregnancy or while breastfeeding

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Related links

Pregnancy
Hypertensive disorders of pregnancy: Clinical practice
Routine prenatal care: Clinical practice
Allergic Rhinitis
Antihistamines for allergies
Nasal, oral and pharyngeal diseases: Pathology review

Resources for research and reference

Bowers, N. (2016, April 12). Pregnancy rhinitis: Relief for ongoing nasal congestion is possible. In Nationwide Children’s Hospital: Family resources & education. Retrieved April 9, 2021, from https://www.nationwidechildrens.org/family-resources-education/family-resources-library/pregnancy-rhinitis-relief-for-ongoing-nasal-congestion-is-possible

Dzięciołowska-Baran, E., Teul-Świniarska, I., Gawlikowska-Sroka, A., Poziomkowska-Gęsicka, I., & Zietek, Z. (2013). Rhinitis as a cause of respiratory disorders during pregnancy. Advances in Experimental Medicine and Biology, 755: 213-220. DOI: 10.1007/978-94-007-4546-9_27

Ellegård, E., & Karlsson, G. (1999).  Nasal congestion during pregnancy. Clinical Otolaryngology and Allied Sciences, 24(4): 307-311. DOI: 10.1046/j.1365-2273.1999.00264.x

Horsager-Boehrer, Robyn (2020, October 6). Baby (and tissues!) on board: Tips for managing pregnancy rhinitis. In UT Southwestern Medical Center: MedBlog. Retrieved from https://utswmed.org/medblog/pregnancy-stuffy-nose-rhinitis/

Pregnancy, Birth and Baby. (2020). Pregnancy rhinitis. Retrieved on April 9, 2021, from https://www.pregnancybirthbaby.org.au/pregnancy-rhinitis

Wisner, W., & Levine, B. (2021). What is Pregnancy Rhinitis? In Verywell Family: Pregnancy. Retrieved April 10, 2021, from https://www.verywellfamily.com/what-is-pregnancy-rhinitis-5104698