title: Association between Bell's palsy in pregnancy and pre-eclampsia.
abstract: BACKGROUND
  Previous published case series have suggested an association between the onset of Bell's palsy in pregnancy and the risk of pre-eclampsia and gestational hypertension.
  
  
  OBJECTIVE
  To evaluate the period of onset of Bell's palsy in pregnancy and the associated risk of adverse maternal and perinatal events, including the hypertensive disorders of pregnancy.
  
  
  METHODS
  Case series study of consecutive female patients.
  
  
  METHODS
  Women presenting with Bell's palsy during pregnancy or the puerperium were identified by a hospital record review at five Canadian centres over 11 years. Information was abstracted about each woman's medical and obstetrical history, period of onset of Bell's palsy, and associated maternal complications, including pre-eclampsia and gestational hypertension as well as preterm delivery and low infant birth weight (<2500 g). These rates were compared to those previously described for the province of Ontario or for Canada.
  
  
  RESULTS
  Forty-one patients were identified. Mean onset of Bell's palsy was 35.4 weeks gestation (SD 3.9). Nine (22.0%, 95%CI 10.8-35.7) were also diagnosed with pre-eclampsia and three (7.3%, 95%CI 1.4-17.1) with gestational hypertension, together (29.3%, 95%CI 16.5-43.9) representing nearly a five-fold increase over the expected provincial/national average. There were three twin births. The observed rates of Caesarean (43.6%) and preterm (25.6%) delivery, as well as low infant birth weight (22.7%), were also higher than expected, although the rate of congenital anomalies (4.5%) was not.
  
  
  CONCLUSIONS
  The onset of Bell's palsy during pregnancy or the puerperium is probably associated with the development of the hypertensive disorders of pregnancy. Pregnant women who develop Bell's palsy should be closely monitored for hypertension or pre-eclampsia, and managed accordingly.
authors.affiliation: Department of Medicine, Sunnybrook and Women's College Health Science Centre, Toronto, Ontario, Canada.
authors.forename: D
authors.initials: D
authors.lastname: Shmorgun
authors.forename: W-S
authors.initials: WS
authors.lastname: Chan
authors.forename: J G
authors.initials: JG
authors.lastname: Ray
mesh_terms: D000328:Adult; D020330:Bell Palsy / Q000209:etiology*; D005260:Female; D006801:Humans; D011225:Pre-Eclampsia / Q000209:etiology*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000209:etiology*; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third; D011644:Puerperal Disorders / Q000209:etiology; D012189:Retrospective Studies; D013997:Time Factors