Abstract
INTRODUCTION: The inner ear is a complex sensory organ with finely balanced physiology; disrupting this may cause hearing changes or vestibular symptoms. Pregnancy involves multiple significant reversible alterations in physiological state. This study reviews literature on the inner ear in pregnancy. METHODS: The review was pre-registered on the PROSPERO database CRD42023446898. Robust searches were conducted by two independent researchers according to the PRISMA 2020 guideline. RESULTS: A total of 69 studies were filtered into the final analysis. Consistent evidence of subclinical hearing loss in pregnancy was identified, which resolved following childbirth. Auditory processing is affected by pregnancy. Vestibular dysfunction may contribute to pregnancy nausea. Sudden sensorineural hearing loss does not occur more frequently in pregnancy. CONCLUSION: This review summarises evidence for reversible and irreversible changes to hearing and vestibular function in pregnancy and pregnancy-related conditions, reviewing aetiological theories and offering insight to audiovestibular physiology and explaining audiovestibular symptoms in the pregnant patient.