Sore throat in pregnancy: Etiology, diagnosis, and evidence-based safe management
Keywords:
antibiotic stewardship, Group A Streptococcus, laryngopharyngeal reflux, pharyngitis, pregnancy, sore throat, upper respiratory tract infectionAbstract
Sore throat (pharyngitis) is one of the most common otolaryngological complaints in pregnancy, most frequently caused by viral upper respiratory tract infections. Pregnancy induces immunological modulation, hormonal changes, and mechanical effects that increase susceptibility to infectious and non-infectious causes, including laryngopharyngeal reflux. While most cases are self-limited, prompt identification of bacterial pharyngitis—particularly Group A β-haemolytic Streptococcus (GAS)—is essential to prevent maternal complications such as invasive disease and obstetric sequelae, including preterm labour. This narrative review summarizes the etiology, pathophysiology, clinical evaluation, diagnosis, and management of sore throat in pregnancy. Non-pharmacological measures and acetaminophen are first-line for symptom relief. For confirmed GAS, penicillin V or amoxicillin remains the antibiotic of choice. Emphasis is placed on risk stratification using clinical scores, antibiotic stewardship, and foetal-safe care. Early recognition and individualized management minimize risks to the mother and foetus. Further prospective studies are needed to strengthen pregnancy-specific guidelines.
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