Clinical Reviews in Allergy & Immunology

, Volume 27, Issue 2, pp 159–177 | Cite as

Diagnosis and treatment of allergic rhinitis and sinusitis during pregnancy and lactation

  • Gary A. Incaudo
The Clinical Practice of Allergy

Abstract

Upper airway congestive symptoms during pregnancy have been recognized since the late 19th century (1). Among randomly selected pregnancies, as many as 18–30% of patients will report substantial symptoms of rhinitis and sinusitis, and this figure may be higher among patients with pre-existing atopic disease (2–4). “Rhinitis of pregnancy” can take many forms. In another chapter in this review, Dr. Elergard discusses a form of rhinitis in pregnancy that occurs as a result of physiologic changes specific to pregnancy. This is to be distinguished from other forms of rhinitis coincident sometimes aggravated by pregnancy such as allergic rhinitis and sinusitis.

The incidence of allergic conditions is 20–30% among women of childbearing years (5). Of those pregnant women with known allergies, some studies suggest that as many as 10–30% will experience increasing allergic symptoms during their pregnancy returning to their normal pre-pregnancy state after delivery (5–7). Postulated causes include those responsible for “rhinitis of pregnancy” such as increased circulating blood volume giving rise to nasal vascular engorgement and hormonal influences on nasal mucosal secretions and have been discussed in another chapter of this review (8, 9).

Index Entries

Chronic rhinitis pregnancy upper airway congestion viral infections nasopathology 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    MacKinzie, J. N. (1898), Alienst. and Neurol. 19, 219–239.Google Scholar
  2. 2.
    Ellegard, E., and Karlsson, G. (1999), Clin. Otolaryngol. 24(4), 307–311.PubMedGoogle Scholar
  3. 3.
    Mabry, R. L. (1986), Southern Medical Journal 79, 965–971.PubMedGoogle Scholar
  4. 4.
    Mabry, R. L. (1980), South Med. J. 73, 1176–1179.PubMedGoogle Scholar
  5. 5.
    Schatz, M., and Zeiger, R. S. (1988), Allergy Proc. 9, 545–554.PubMedGoogle Scholar
  6. 6.
    Hamano, N., Terada, N., Maesako, K., Numata, T., and Konno, A. (1998), Allergy and Asthma Proc. 19(5), 263–269.Google Scholar
  7. 7.
    Terada, N., and Konno, A. (1992), Obstet. Gynecol. 59, 31–36.Google Scholar
  8. 8.
    Toppozada, H., Michaels, L., Toppazada, M., El-Ghazzawi, I., Talaat, M., and Elwany, S. (1982), J. Laryngol. and Otol. 96, 613–626.Google Scholar
  9. 9.
    Sorri, M., Bortikanen-Sorri, A. L., and Karja, J. (1980), Rhinology 18, 83–86.PubMedGoogle Scholar
  10. 10.
    Lekas, M. D. (1992), Otolarngol-Head and Neck Surgery 107(6 Pt. 2), 845–848.Google Scholar
  11. 11.
    Foxen, E. H., Preston, T. D., and Lack, J. A. (1971), J. Laryngol. Otol. 85, 811–825.PubMedGoogle Scholar
  12. 12.
    Falkoff, R. (1987), Clin. Rev. All. 5, 287–300.Google Scholar
  13. 13.
    Dzhabbarov, K. K., and Muminov, A. I. (1993), Vestn. Otorinolaringol. Sep–Dec;(5–6), 42–45.Google Scholar
  14. 14.
    Falkoff, R. (1998), In Asthma and Immunological Diseases in Pregnancy and Early Infancy (Lung Biology in Health and Disease, vol. 110), Schatz, M., Zeiger, R. S., and Claman, H. N., eds., New York. Marcel Decker, pp. 73–90.Google Scholar
  15. 15.
    Derkay, C. S. (1988), Otolaryn.-Head and Neck Surg. 99, 558–566.Google Scholar
  16. 16.
    Plate, S., Johnsen, N. J., Pedersen, S. N., and Thomsen, K. A. (1979), Clin. Otolaryngol. 4, 393–400.PubMedGoogle Scholar
  17. 17.
    Ellegård, E., Hellgren, M., Torén, K., and Karlsson, G. (2000), Gynecol. Obstet. Invest. 49, 98–101.PubMedGoogle Scholar
  18. 18.
    Spector, S. L., and Nicklas, R. A. (1995), J. Allergy Clin. Immunol. (suppl)96, 732–748.Google Scholar
  19. 19.
    Lockey, R. F., Benedict, L. M., Turkeltaub, P. C., and Bukantz, S. C. (1987), JACI 79, 660–665.Google Scholar
  20. 20.
    Schatz, M. (1998), J. Allergy Clin. Immunol. 101(2), 373–377.Google Scholar
  21. 21.
    Schatz, M., and Zeiger, R. S. (1997), Clin. Perinatol. 24(2), 407–432.PubMedGoogle Scholar
  22. 22.
    Lipkowitz, M. A., Schatz, M., Cook, T. J., et al. (1998), Ann. Allergy Asthma Immunol. 81(1), 30–34.PubMedGoogle Scholar
  23. 23.
    Incaudo, G. A., Gershwin, M. E., and Nagy, S. M. (1986), Allergol. et Immunopathol. 14, 423–434.Google Scholar
  24. 24.
    Fattibene, P., Mazzei, F., Nuccetelli, C., and Risicia, S. R. (1999), Acta Paediatr. 88(7), 693–702.PubMedGoogle Scholar
  25. 25.
    Ornoy, A., Patlas, N., and Schwartz, L. (1996), Isr. J. Med. Sci. 32(2), 112–115.PubMedGoogle Scholar
  26. 26.
    Toppenberg, K. S., Hill, D. A., and Miller, D. P. (1999), Am. Fam. Physician 59(7), 1813–1820.PubMedGoogle Scholar
  27. 27.
    Landman, M. D. (1986), Otolaryngol-Head and Neck Surg. 94, 157–154.Google Scholar
  28. 28.
    Rohr, A. S., Spector, S. L., Siegel, S. C., et al. (1986), J. Allergy Clin. Immunol. 78(1), 58–61.PubMedGoogle Scholar
  29. 29.
    Berger, W. E. (1986), Ann. Allergy 56(1), 39–43.PubMedGoogle Scholar
  30. 30.
    Shapiro, G. G., Furukawa, C. T., Pierson, W. E., et al. (1986), J. Allergy Clin. Immunol. 77(1 Pt. 1), 59–64.PubMedGoogle Scholar
  31. 31.
    McCombs, J. (1997), In Pharmacotherapy: A Pathophysiologic Approach, 3rd ed., DiPiro, J. T., Talbert, R. L., Yee, G. C., Matzke, G. R., Wells, B. G., and Posey, L. M., eds., Stamford, CT, Appleton & Lange, pp. 1565–1583.Google Scholar
  32. 32.
    Loebstein, R., Lalkin, A., and Koren, G. (1997), Clin. Pharmacokinet. 33(5) 328–343.PubMedGoogle Scholar
  33. 33.
    Food and Drug Administration. (1979), Federal Register 44(124), 37,434–37,467.Google Scholar
  34. 34.
    Heinonen, O. P., Slone, D., and Shapiro, S. (1977), Birth Defects and Drugs in Pregnancy. Littleton, MA, Publishing Sciences Group.Google Scholar
  35. 35.
    Aselton, P., Jick, H., Milunsky, A., et al. (1985), Obstet. Gynecol. 65(4), 451–455.PubMedGoogle Scholar
  36. 36.
    Jick, H., Watkins, R. N., Hunter, J. R., et al. (1979), N. Engl. J. Med. 300, 218–222.PubMedCrossRefGoogle Scholar
  37. 37.
    Mazzotta, P., Loebstein, R., and Koren, G. (1999), Drug Safety 20(4), 361–375.PubMedGoogle Scholar
  38. 38.
    Mazzotta, P., Loebstein, R., and Koren, G. (1999), Practical Drug Safety 4, 361–365.Google Scholar
  39. 39.
    Dombrowski, M. P., Huff, R., Lipkowitz, M., and Schatz, M. (2000), Ann. Allergy, Asthma, Immunol. 84, 475–480.Google Scholar
  40. 40.
    Howard, C. R., and Lawrence, R. A. (1999), Clin. Perinatol. 26(2), 447–478.PubMedGoogle Scholar
  41. 41.
    Logsdon, B. A. (1997), J. Am. Pharm. Assoc (Wash.) 37(4), 407–418.Google Scholar
  42. 42.
    American Academy of Pediatrics Committee on Drugs. (1994), Pediatrics 93, 127.Google Scholar
  43. 43.
    Dillon, A. E., Wagner, C. L., Wiest, D., and Newman, R. B. (1997), Obstet. Gynecol. Clin. North Am. 24(3), 675–696.PubMedGoogle Scholar
  44. 44.
    Ressel, G. (2002), Am. Fam. Physician 65(5), 979–980.PubMedGoogle Scholar
  45. 45.
    Rothman, K. J., Fyler, D. C., Goldblatt, A., et al. (1979), Am. J. Epidemiol. 109(4), 433–439.PubMedGoogle Scholar
  46. 46.
    Werler, M. M., Mitchell, A. A., and Shapiro, S. (1992), Teratology 45, 361–367.PubMedGoogle Scholar
  47. 47.
    Zierler, S., and Rothman, K. J. (1985), N. Engl. J. Med. 313(6), 347–352.PubMedCrossRefGoogle Scholar
  48. 48.
    Ballen, J. C., ed. (1980) American Medical Association Drug Evaluation. Amer. Med. Assoc., Chicago.Google Scholar
  49. 49.
    Baxi, L. V., Gindoff, P. R., Pregenzer, G. J., et al. (1985), Am. J. Obstet. Gynecol. 153, 799.PubMedGoogle Scholar
  50. 50.
    Jick, H., Holmes, L. B., Hunter, J. R., et al. (1981), JAMA 246(4), 343–346.PubMedGoogle Scholar
  51. 51.
    Briggs, G. G., Freeman, R. K., and Yaffe, SJ. (1994), Drugs in Pregnancy and Lactation. Baltimore, Williams and Wilkins.Google Scholar
  52. 52.
    Torfs, C. P., Katz, E. A., Bateson, T. F., Lam, P. K., and Curry, C. J. (1996), Teratology 54, 84–92.PubMedGoogle Scholar
  53. 53.
    Seto, A., Einarson, T., and Koren, G. (1993), Reprod. Toxicol. 7(4), 393–395.PubMedGoogle Scholar
  54. 54.
    Smith, C. V., Rayburn, W. F., Anderson, J. C., et al. (1990), Obstet. Gynecol. 76, 803–806PubMedCrossRefGoogle Scholar
  55. 55.
    Rayburn, W. F., Anderson, J. C., Smith, C. V., et al. (1990), Obstet. Gynecol. 76, 180–182.PubMedGoogle Scholar
  56. 56.
    Briggs, G. G., Freeman, R. K., Yaffe, S. J., eds. (1998), Drugs in Pregnancy and Lactation, 5th ed., Baltimore, Williams & Wilkins, pp. 743–744.Google Scholar
  57. 57.
    Incaudo, G. A. (1988), In Asthma and Immunological Diseases in Pregnancy and Early Infancy, Lung Biology in Health and Disease, vol 110, Schatz, M., Zeiger, R. S., Claman, H. N., eds., New York, Marcel Decker, pp. 279–313.Google Scholar
  58. 58.
    Saxin, I. (1974), Lancet 1, 407.Google Scholar
  59. 59.
    Parkin, D. E. (1974), J. Ped. 85, 580.Google Scholar
  60. 60.
    Einarson, A., Bailey, B., Jung, G., Spizzirri, D., Baillie, M., and Koren, G. (1997), Annals of Allergy 78, 183–186.Google Scholar
  61. 61.
    Nelson, M. M., and Forfar, J. O. (1971), Br. Med. J. 1, 523–527.PubMedCrossRefGoogle Scholar
  62. 62.
    Moretti, M. E., Caprara, D., Countiho, C. J., et al. (2003), J. Allergy Clin. Immunol. 111, 479–483.PubMedGoogle Scholar
  63. 63.
    Schatz, M., and Petitti, D. (1997), Ann. Allergy 78, 157–159.CrossRefGoogle Scholar
  64. 64.
    Prenner, B. M. (1977), Am. J. Dis. Child. 131, 529.PubMedGoogle Scholar
  65. 65.
    Zierler, S., and Purohit, D. (1986), Am. J. Epidemiol. 123(1), 192–196.PubMedGoogle Scholar
  66. 66.
    Ito, S., Blajchman, A., Stephenson, M., Eliopoulos, C., and Koren, G. (1993), Am. J. Obstet. Gynecol. 168(5), 1393–1399.PubMedGoogle Scholar
  67. 67.
    Kok, T. H. H. G., Taitz, L. S., Bennett, M. J., and Holt, D. W. (1982), Lancet 1, 914.PubMedGoogle Scholar
  68. 68.
    Ghaeli, P., and Kaufman, M. B. (1993), J. Hum. Lact. 9(4), 261–262.PubMedGoogle Scholar
  69. 69.
    Blackburn, W. R., Kaplan, H. S., and McKay, D. G. (1965), Am. J. Obstet. Gynecol. 92, 234–236.PubMedGoogle Scholar
  70. 70.
    Fraser, F. C., Watter, B. E., and Fainstat, J. D. (1954), J. Cell Comp. Physiol. 43(supp. 1), 237–245.Google Scholar
  71. 71.
    Carmichael, S. L., and Shaw, G. M. (1999), Am. J. Med. Genet. 86, 242–244.PubMedGoogle Scholar
  72. 72.
    Rodriguez-Pinilla, E., and Martinez-Frias, M. L. (1998), Teratol. 58, 2–5.Google Scholar
  73. 73.
    Diaz-Citrin, O., Park, L., Pastuszak, A., et al. (1998), Terratol. 57, 153–262.Google Scholar
  74. 74.
    Kallen, B., Rydhstroem, H., and Aberg, A. (1999), Obstet. Gynecol. 93(3), 392–395.PubMedGoogle Scholar
  75. 75.
    Schatz, M. (1997), Drug Saf. 16(5), 342–350.PubMedGoogle Scholar
  76. 76.
    Norjavaara, E., and Gerhardsson de Verdier, M. (2003), JACI 111, 736–742.Google Scholar
  77. 77.
    Ellegaard, E. K., Hellgren, M., and Karlsson, N. G. (2001), Clin. Otolaryngol. 26, 394–400.Google Scholar
  78. 78.
    Hill, R. M., and Tennyson, L. M. (1984), Immunol. Allergy Prac. 6, 221–227.Google Scholar
  79. 79.
    Wilson, J. (1982), J. Pharm. Med. 8, 45–51.Google Scholar
  80. 80.
    Talbot, A. R., Herr, T. M., and Parsons, D. S. (1997), Laryngoscope 107, 500–503.PubMedGoogle Scholar
  81. 81.
    Shoseyov, D., Bibi, H., Shai, P., Shoseyov, N., Shazberg, G., and Hurvitz, H. (1998), J. Allergy Clin. Immunol. 101, 602–605.PubMedGoogle Scholar
  82. 82.
    Anglen, J. O., Apostoles, S., Christensen, Gainor, B. (1994), J. Orthop. Trauma 8, 390–396.PubMedGoogle Scholar
  83. 83.
    Adam, P., Stiffman, M., and Blake, R. L. (1998), Arch. Fam. Med. 7, 39–43.PubMedGoogle Scholar
  84. 84.
    Turnbull, G. L., Rundell, O. H., Rayburn, W. F., et al. (1996), J. Reprod. Med. 41, 897–902.PubMedGoogle Scholar
  85. 85.
    Louis, B., Escudier, E., Blumen, B., Coste, A., Zerah, F., Peynagre, R., et al. (2001), Laryngoscope 111(5), 894–899.PubMedGoogle Scholar
  86. 86.
    Rambur, B. (2002), J. Amer. Acad. of Nurse Pract. 14, 527–530.Google Scholar
  87. 87.
    Erasmus, C., Blackwood, W., and Wilson, J. (1982), Arch. Dis. Child. 57, 785–787.PubMedGoogle Scholar
  88. 88.
    Schatz, M., Hoffman, C. P., Zeiger, R. S., Falkoff, R., and Mellon, M. (1988), In Allergy: Principles and Practice, 3rd ed. Middleton, E., Jr., Reed, C. E., Ellis, E. F., Adkinson, N. F., Jr., Yunginger, J. W., eds., CV Mosby Co, pp. 1093–1155.Google Scholar
  89. 89.
    Francis, N. (1941), J. Allergy 12, 559–563.Google Scholar
  90. 90.
    Chester, S. W. (1950), Ann. Allergy 8, 772–773.PubMedGoogle Scholar
  91. 91.
    Maietta, A. L. (1955), Ann. Allergy 13, 516–522.PubMedGoogle Scholar
  92. 92.
    Schaefer, G., and Silverman, F. (1961), Am. J. Obstet. Gynecol. 82, 162.Google Scholar
  93. 93.
    Metzger, W. J., Turner, E., and Patterson, R. (1978), JACI 61(4), 268–272.Google Scholar
  94. 94.
    Shaikh, W. A. (1993), Clin. Exp. Allergy 23, 857–860.PubMedGoogle Scholar
  95. 95.
    Metzger, W. J., Turner, E., and Patterson, R. (1978), J. Allergy Clin. Immunol. 61, 268–271.PubMedGoogle Scholar
  96. 96.
    Greenberger, P. A. (1985), Chest 87(Suppl), 85S-87S.PubMedGoogle Scholar
  97. 97.
    Metzger, W. J. (1990), Compr. Ther. 16(3), 17–26.PubMedGoogle Scholar
  98. 98.
    Charles, D. (1979), Obstet. Gynecol. Annu. 8, 19–25.PubMedGoogle Scholar
  99. 99.
    Schwerz, R. H. (1981), Obstet. Gyneco., (Suppl)58, 955–956.Google Scholar
  100. 100.
    Schwerz, R. H., and Crombleholme, W. (1980), Prog. Clin. Biol. Res. 44, 97–107.Google Scholar
  101. 101.
    Dashe, J. S., and Gilstrap, L. C., 3rd. (1997), Obstet. Gynecol. Clin. North Am. 24(3), 617–629.PubMedGoogle Scholar
  102. 102.
    Holt, G. R., and Mabry, R. L. (1983), Otolaryngol.-Head & Neck Surg. 91, 338–341.Google Scholar
  103. 103.
    Garland, S. M., and O'Reilly, M. A. (1995), Drug Saf. 13(3), 188–205.PubMedGoogle Scholar
  104. 104.
    Philipson, A. (1979), Clin. Pharmacokinet. 4, 297–309.PubMedGoogle Scholar
  105. 105.
    Berkovitch, M., Segal-Socher, I., Greenberg, R., Bulkowshtein, M., Arnon, J., Merlob, P., and Or-Noy, A. (2000), Brit. J. Clin. Pharmacol. 50, 161–165.Google Scholar
  106. 106.
    Manka, W., Solowiow, R., and Okrzeja, D. (2000), Drug Saf. 22, 83–88.PubMedGoogle Scholar
  107. 107.
    Einarson, A., Phillips, E., Mawji, F., D'Alimonte, D., Schick, B., Addis, A., et al. (1998), Am. J. Perinatol. 15(9), 523–525.PubMedGoogle Scholar
  108. 108.
    Drinkard, C. R., Shatin, D., and Clouse, J. (2000), Pharmacoepidemiol. Drug Saf. 9, 549–556.PubMedGoogle Scholar
  109. 109.
    Duff, P. (1997), Infect. Dis. Clin. North Am. 11(1), 1–12.PubMedGoogle Scholar
  110. 110.
    Berkovitch, M., Pastuszak, A., Gazarian, M., Lewis, M., and Koren, G. (1994), Obstet. Gynecol. 84(4), 535–538.PubMedGoogle Scholar
  111. 111.
    Lipsky, B. A., and Baker, C. A. (1999), Clin. Infect. Dis. 28(2), 352–364.PubMedGoogle Scholar
  112. 112.
    Peled, Y., Friedman, S., Hod, M., and Merlob, P. (1991), DICP 25(11), 1181–1182.PubMedGoogle Scholar
  113. 113.
    Schluter, G. (1989), Am. J. Med. 87(5A), 37S-39S.PubMedGoogle Scholar
  114. 114.
    Wilton, L. V., Pearce, G. L., and Mann, R. D. (1996), Br. J. Clin. Pharmacol. 41(4), 277–284.PubMedGoogle Scholar
  115. 115.
    Lemanske R. (1998), J. Allergy and Clin. Immunol. 101, 392–396.Google Scholar

Copyright information

© Humana Press Inc. 2004

Authors and Affiliations

  • Gary A. Incaudo
    • 1
  1. 1.Division of Rheumatology, Allergy, and Clinical ImmunologyUniversity of California, Davis School of MedicineUSA

Personalised recommendations