Impact of pregnancy-associated Bell's palsy on quality of life and self-perception: A mixed methods study

Pregnancy and Bell's palsy both cause physical, psychological and social challenges. Incidence of Bell's palsy rises in the third trimester of pregnancy and postpartum, yet few studies have explored the lived experiences of pregnancy-associated Bell's palsy.

To assess the impact of pregnancy-associated Bell's palsy on quality of life and self-perception compared to Bell's palsy unrelated to pregnancy.

This survey study used a convergent mixed methods approach. Seventeen participants were recruited from the Sydney Facial Nerve Clinic. Data collected included demographics, clinical information, open-ended responses and patient-reported outcome measures. Quality of life was measured by the Facial Disability Index and a questionnaire, while self-perception was assessed with the Mirror Gazing Cognition and Affect Rating Scale. Associations between pregnancy status and the outcome measures were analysed using the Mann-Whitney U test. Other predictors were identified using the Fisher's exact test and regression models. Thematic analysis was performed on qualitative data.

Age was inversely associated with appearance-related distress (β=-.593, p=.025), with younger women having greater distress. No statistically significant differences in quality of life and self-perception scores were found between Bell's palsy and pregnancy-associated Bell's palsy groups. Thematic analysis identified 5 main themes: experience with healthcare, body image, impact on daily life, improving healthcare, and impact of pregnancy-associated Bell's palsy.

This study highlights the functional and psychosocial challenges faced by pregnancy-associated Bell's palsy patients. Targeted treatment guidance, referral pathways and specific support for pregnancy-associated Bell's palsy are warranted to improve patient outcomes.