Gestational Neuro-Otological Manifestation Patterns Across Trimesters in Karachi, Pakistan: A Retrospective Cross-Sectional Study.

OBJECTIVE

To determine the prevalence and trimester-specific trends of neuro-otological manifestations among pregnant women attending antenatal care in tertiary care hospitals at Karachi, Pakistan.

METHODOLOGY: A prospective, multicenter observational study was conducted from January 2020 to December 2024 at two tertiary hospitals in Karachi. A total of 1,230 pregnant women aged 18-45 years were enrolled through non-probability consecutive sampling. Data were collected using a validated three-part assessment tool encompassing demographic characteristics, otological symptoms, and neurological/vestibular presentations. Statistical analysis was performed using SPSS software version 26 (IBM Corp., Armonk, NY). Chi-square and Fisher's exact tests were applied, with significance defined as P < 0.05.

RESULTS

Neuro-otological symptoms were highly prevalent. Otological complaints were reported in 874 (71%) participants, most commonly tinnitus in 390 (31.7%) and ear fullness in 310 (25.2% ). Neurological and vestibular manifestations were observed in 847 (69%), with vertigo (304, 24.7%), headache (260, 21.1%), and dizziness (215, 17.5%) being the most frequent. A significant increase in the frequency of symptoms was noted with advancing gestational age, with the third trimester demonstrating the highest burden across most manifestations (P < 0.001).

CONCLUSIONS

Neuro-otological manifestations are common during pregnancy and exhibit a trimester-dependent rise, peaking in late gestation. Routine screening and early recognition within antenatal care may help prevent misdiagnosis, reduce patient distress, and improve maternal quality of life.