A longitudinal study of facial function, quality of life, and depression in Bell’s palsy during pregnancy and puerperium

Bell's palsy can reduce facial function and quality of life. Pregnancy may also be physically and psychologically challenging. This study investigates depression among pregnant and puerperal women with and without Bell's palsy and if degree of facial palsy and depression was correlated. Thirty-one women with pregnancy-associated Bell's and 31 women without Bell's palsy were prospectively included and followed one year at two University Hospitals, Stockholm. Depression was assessed with Edinburgh Postnatal Depression Scale (EPDS). In women with Bell's palsy, Facial Disability Index (FDI), Facial Clinimetric Evaluation (FaCE) scale, and Sunnybrook Facial Grading System (SFGS) were collected. The association between Bell's palsy and EPDS ≥ 11 was assessed by logistic regression, and between EPDS and FDI, FaCE, and SFGS, respectively, by Spearman rank correlation. Median EDPS did not differ between groups (7.0 vs. 6.0, p = 0.74, one month, 6.5 vs. 6.0, p = 0.87, 12 months). EPDS at one month was correlated to FDI (p = 0.002) and FaCE (p = 0.004) and at 12 months to FDI (p = 0.009) but not to FaCE (p = 0.08). No correlation was found between EPDS and SFGS. In summary, no association appeared between pregnancy-associated Bell's palsy and depression. Patient-reported function correlated well with depression in pregnancy-associated Bell's palsy, while physician-reported facial function did not.