Pregnancy and Parity as Risk Factors for Recurrence in Idiopathic Subglottic Stenosis.

Abstract

This study aims to evaluate the impact of parity on the severity and recurrence rates of idiopathic subglottic stenosis (iSGS) in premenopausal females. A retrospective cohort study. Two tertiary care centers from 2002 to 2024. We analyzed premenopausal iSGS patients under 40 years who underwent balloon dilation or laser wedge excision. Clinical features, including demographics and pregnancy history, were examined. Recurrence rates between nulliparous and parous patients were compared using Poisson regression, adjusting for age and follow-up duration. Linear regression assessed the relationship between pregnancy and iSGS recurrence. Forty-eight patients were included, with 36 parous and 12 nulliparous. Adjusting for age and follow-up, the mean recurrence rate was 2.6 times higher in parous patients (95% confidence interval [CI]: [1.5, 4.8], P = .0008). Each additional pregnancy was associated with 0.81 additional recurrences (95% CI: [0.05, 1.57], P = .0375). No significant differences in surgery-free time were observed between groups. Parity and pregnancy significantly increase the risk of iSGS recurrence, although they do not accelerate subsequent recurrences. Health care providers should counsel women of childbearing age about these risks in family planning discussions, emphasizing shared decision-making regarding potential surgical interventions.