Perinatal outcomes in pregnancy with allergic rhinitis across seasons and postpartum status, stratified by depression presence: A retrospective cohort analysis

Abstract

Objective The goal of this study was to investigate the factors that influence postpartum depression in pregnant women with allergic rhinitis (AR). Methods We conducted a retrospective cohort study that included women with AR between June 2015 to June 2019 in Harvard University Partners Healthcare Systems (PARTNERS) in the USA. The study group was divided into postpartum depression and non-postpartum depression. Routine clinical and laboratory information was collected. Univariate and multivariate logistic regression analysis was used to study associations between AR women pregnant in the pollen seasons and adverse outcomes. Additionally, the receiver operating characteristic (ROC) curve evaluates discriminative ability by the area under the ROC curve (AUC). The calibration curve (DCA) was conducted to determine the clinical utility and benefit of the nomogram. Results A total of 216 pregnant women with AR participated in this study. Univariate analysis showed that 7 indicators were significantly different (P<0.05). We conducted LASSO analysis and multivariate regression to establish a postpartum depressionnomogram during the AR pregnants, the four selected risk predictors are as follows: pollen season pregnancy (OR=1.514, 95%CI: 0.771-2.973), history of preterm birth (OR=2.723, 95%CI: 1.157-6.406), number of pregnancies (OR=2.104, 95%CI: 1.356-3.267), anti-allergy medication during pregnancy (OR=2.975, 95%CI: 1.521-5.819). The calibration curve and DCA present optimal predictive power. DCA demonstrates that the nomogram could be applied clinically. Conclusions We highlighted the comorbidity of AR and postpartum depression, and suggested that a multidisciplinary consideration between allergists and obstetricians or midwives is needed to ensure that pregnant women consult experts to reduce AR symptoms.