Abstract: Background: Laryngopharyngeal Reflux (LPR) is a prevalent yet often underestimated manifestation in pregnancy. While mechanical compression by the gravid uterus is a known factor, the role of hormonal relaxation of the Upper Esophageal Sphincter (UES) remains a subject of debate.
Objective: To assess the severity of LPR in third-trimester pregnant women compared to non-pregnant controls and to correlate these findings with serum progesterone levels.
Methods: A prospective comparative study was conducted at Srinivas Medical College, Mangalore, from January 2024 to December 2024. The study included 60 pregnant women in their third trimester (Group A) and 60 age-matched non-pregnant controls (Group B). LPR was evaluated subjectively using the Reflux Symptom Index (RSI) and objectively using the Reflux Finding Score (RFS) via 70-degree rigid laryngoscopy. Serum progesterone levels were analyzed in Group A to assess hormonal correlation.
Results: Group A demonstrated significantly higher mean RSI (18.4±4.2 vs. 9.1±3.5, p<0.001) and RFS (10.8±2.9 vs. 4.5±1.8, p<0.001) compared to Group B. The most common laryngoscopic findings in pregnant women were posterior commissure hypertrophy (85%) and arytenoid erythema (78%). A strong positive correlation was observed between serum progesterone levels and RFS scores in the pregnant group (r = 0.71, p<0.001).
Conclusion: Pregnancy significantly exacerbates signs and symptoms of LPR. The strong correlation with progesterone suggests that hormonal relaxation of the sphincter mechanism plays a pivotal role, likely synergistic with mechanical abdominal pressure.
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