When Does Pregnancy Rhinitis Start [work] -

Pregnancy rhinitis is defined by the European Academy of Allergy and Clinical Immunology as nasal congestion lasting six or more weeks during pregnancy, without other signs of infection or allergy, and with complete resolution within two weeks after delivery. Despite affecting an estimated 20–40% of pregnant individuals, its exact pathophysiology remains under study, with proposed mechanisms including elevated estrogen, progesterone, and increased blood volume leading to nasal mucosal edema and glandular hyperreactivity.

Pregnancy rhinitis most commonly begins in the second trimester, with a peak at 18–20 weeks , though a minority of cases start in the first or third trimesters. Clinicians should educate patients about this timeline to avoid unnecessary antibiotics or allergy testing. Treatment remains symptomatic (saline irrigations, sleep with head elevated, and intranasal corticosteroids for severe cases), with reassurance that onset timing does not affect fetal or maternal outcomes.

Onset of Pregnancy Rhinitis: A Review of Gestational Timing and Clinical Presentation