Prevalence of olfactory dysfunction among postpartum women and impact of SARS-CoV-2 infection during pregnancy

Olfactory dysfunction resulting from COVID-19 has imparted a lasting impact on olfaction among the general public, including pregnant women contracting SARS-CoV-2 infection. While olfactory dysfunction can impact physical, mental, and psychosocial well-being, there has been little research on olfaction during pregnancy and postpartum, nor the impact of SARS-CoV-2 infection on olfaction while pregnant. Therefore, the primary study aims are to evaluate olfaction in the postpartum period and determine the impact of antecedent SARS-CoV-2 infection. We recruited two cohorts of postpartum women, those with a history of SARS-CoV-2 infection before or during pregnancy (COVID cohort; n = 109) and those without (non-COVID cohort; n = 226), and evaluated their olfaction during the postpartum period by administering the University of Pennsylvania Smell Identification Test. Participants were queried about demographics, past SARS-CoV-2 infections, self-reported sense of smell (both in overall ability to smell and for the presence of qualitative smell issues such as parosmia and phantosmia), and perceived cause of smell loss, if any. We found significantly fewer postpartum women with normosmia capabilities in both COVID (27%) and non-COVID (46%) cohorts compared to normative data for aged-matched (30 to 39 years) women (83%). Women in the non-COVID cohort had significantly higher UPSIT scores and mean subjective olfaction ratings than those in the COVID cohort (95% CI [0.77,2.41] and 95% CI [-0.83,7.34], respectively). This study reflects the largest published cohort of postpartum women evaluated for olfactory function with standardized psychophysical testing. Our findings suggest both postpartum and SARS-CoV-2 infection are associated with diminished smell function.