Study Highlights Comorbidity of Allergic Rhinitis, Postpartum Depression

A recent study showed fertility, a history of premature birth, and treatment for allergies during pregnancy are risk factors for postpartum depression.1

“Our study underscores the comorbidity of [allergic rhinitis] and [post-partum depression], advocating for multidisciplinary collaboration among allergists, obstetricians, and midwives to provide pregnant women with expert consultation for effective [allergic rhinitis] symptom management,” wrote investigators, led by Fan Li, from the department of otolaryngology-head and neck surgery at Chongqing General Hospital and Yuan Liao, from the department of obstetrics and gynecology and Chongqing General Hospital.

Approximately 1 in 6 people live with allergic rhinitis, with incidence rates of 9% in the US, 19% in Europe, 10% in Africa, 15% in Asia, and 38% in Oceania.2 During pregnancy, increased blood volume and hormonal fluctuations can worsen allergic symptoms in about a third of women, leading to symptoms of rhinorrhea and recurrent sneezing.

Women with allergic rhinitis are at risk of delivering babies pre-term and with a low birth weight. Allergic rhinitis during pregnancy also increases the risk of psychological distress, and conversely, depression makes it more challenging to treat allergies.

Research has previously shown that pregnant women with allergic rhinitis have significantly lower serum vitamin E levels than pregnant women without allergic conditions.3 Additionally, research demonstrated the serum level of vitamin E was negatively correlated with the total nasal symptom score.

Investigators conducted a retrospective cohort study to assess factors influencing postpartum depression in pregnant women with allergic rhinitis.1 The sample included 216 women who self-reported allergic rhinitis and were part of the Harvard University Partners Healthcare Systems (PARTNERS) in the USA between June 2015 and June 2019. This system included 7 hospitals: Brigham and Women’s Hospital, Massachusetts General Hospital, Newton-Wellesley Hospital, North Shore Medical Center, Martha’s Vineyard Hospital, Cooly Dickinson Hospital and Nantucket Cottage Hospital.

The team collected data on age, parity, ethnicity, last menstrual period, BMI, obstetric and medical history, leukocyte, red blood cell, platelet counts, birthweight, child’s sex, delivery mode, Apgar score, pain score, and postpartum depression.

Participants (median age, 34 years; IQR, 31.00 – 27.25) were divided into 2 groups: the postpartum depression (n = 65; median age 35 years, IQR, 31.00 – 38.00) and non-postpartum depression (n = 151; median age 34 years, IQR, 31.00 – 26.00) arm.

The univariate analysis found 7 indicators were significantly different between arms (P < .05), with pregnancy during pollen season, reduced gestational weight gain, and a maternal history of spontaneous abortion linked to a heightened risk of postpartum depression.

Moreover, the least absolute shrinkage and selection operator and multivariable regression identified 4 predictors of postpartum depression in women with allergic rhinitis: pollen season pregnancy (odds ratio [OR], 1.514; 95% confidence interval [CI], 0.771 – 2.973), history of preterm birth (OR, 2.732; 95% CI, 1.157 – 6.406), number of pregnancies (OR, 2.104; 95% CI, 1.356 – 3.267), and anti-allergy medication during pregnancy (OR, 2.975; 95% CI, 1.51 – 5.819).

Investigators pointed out that many women stop taking allergy medications during pregnancy. Yet, if someone's allergies worsen during pregnancy, they may need to continue treatment. They hypothesized that heightened allergic inflammation and allergic rhinitis may increase the risk of postpartum depression.

“In summary, this study suggests that multiparity, a maternal history of premature delivery, and allergy treatments during pregnancy are high-risk factors for [post-partum depression],” the team wrote. “Additionally, being pregnant during the pollen season, insufficient gestational weight gain, and a maternal history of spontaneous abortion also increase the risk… Allergists focus on the diagnosis and treatment of allergic rhinitis, and obstetricians and midwives focus on the management of perinatal period.”

References

1. Li F, Liao Y, Lei C, Zhou J, Li Y, Shi Q. Risk factors for postpartum depression in pregnant women with allergic rhinitis: a retrospective study. BMC Psychiatry. 2025 Mar 25;25(1):276. doi: 10.1186/s12888-025-06702-w. PMID: 40133909; PMCID: PMC11938620.

2. Savouré M, Bousquet J, Jaakkola JJK, Jaakkola MS, Jacquemin B, Nadif R. Worldwide prevalence of rhinitis in adults: A review of definitions and temporal evolution. Clin Transl Allergy. 2022 Mar;12(3):e12130. doi: 10.1002/clt2.12130. PMID: 35344304; PMCID: PMC8967272.

3. Li YT, Lee WL, Wang PH. Is the lower serum level of vitamin E associated with pregnant women with allergic rhinitis? J Chin Med Assoc. 2021;84(8):739–40. https://doi.org/10.1097/JCMA.0000000000000566.Return to ref 8 in article