Role of Lactate Dehydrogenase and Lymphocyte Count as Predictors of Poor Perinatal Outcomes in COVID-19-Infected Pregnancies Requiring Hospitalization and Delivery: A Retrospective Cohort Study.

INTRODUCTION: Physiological, hormonal, or biochemical changes may be related to the increased morbidity of COVID-19 during pregnancy. Our knowledge remains limited about which pregnant women will worsen and develop complications. The aim was to evaluate the maternal, fetal, and neonatal outcomes in hospitalized pregnant women who delivered while infected with acute COVID-19 and to investigate the possible predictors of poor prognosis in a tertiary pandemic center. METHODS: A retrospective cohort study was conducted on pregnant women who required termination or delivery during a COVID-19 infection in a tertiary hospital. Serum markers were analyzed to determine any possible association and the predictive value of these markers to show poor maternal, fetal, and/or neonatal outcomes. RESULTS: Out of 45 patients, 12 had maternal complications (Group 1) and 33 had no maternal complications (Group 2). The mean lymphocyte at hospital admission was measured as 1,175.83 ± 362.0 and 1,735.30 ± 746.1 in Groups 1 and 2, respectively (p=0.02). The lymphocyte count measured at hospital admission showed significance in predicting poor maternal outcome, with an area under the curve (AUC) of 0.737 (95% CI:0.578 to 0.897) and a cut-off value of 1,110 mcL with 82% sensitivity and 67% specificity. Nineteen of the 45 women had fetal complications. Receiver operating characteristic analysis showed maternal lactate dehydrogenase as a significant predictor for poor fetal outcome with a cut-off value of 213 U/L (AUC:0.719; 95% CI:0.566 to 0.872) with 85% sensitivity and 60% specificity. CONCLUSION: The lymphocyte count can be used as a predictor of poor maternal outcome and lactate dehydrogenase demonstrates poor fetal outcome during hospitalization.

Differences in Polysomnography Parameters of Women in the Post and Transitional Phases of Menopause.

Objectives To investigate the relationship between the changes in the main components of sleep during the menopausal transition and the postmenopausal period. Methods A total of 162 patients were included in the study, including 62 patients in the menopausal transition period and 100 patients in the postmenopausal period. The Epworth sleepiness scale (ESS) was applied to the patients before polysomnography (PSG). In PSG recordings, the total sleep time, sleep efficiency, rapid eye movement (REM) sleep (%), non-REM (NREM) sleep (%), apnea-hypopnea index (AHI), REM-AHI, NREM-AHI, minimum and mean oxygen saturation, oxygen desaturation time, and oxygen desaturation index (ODI) were recorded. Results Total sleep time (256.4±89.9 vs. 302.8±73.8, p<.03) and sleep efficiency (63.8±16.3 vs 75.6±16.0, p<.005) were significantly decreased in the postmenopausal patient group compared to the menopausal transition group. ODI, desaturation time, and desaturation percentages were significantly higher and minimum oxygen saturation was significantly lower in the postmenopausal group than in the transitional group. While mild obstructive sleep apnea syndrome (OSAS) rates in the menopausal transition group were significantly higher than in the menopausal group, moderate and severe OSAS rates were significantly higher in the menopausal group. Conclusion Changes in PSG measurements during the menopausal transition and postmenopausal period showed a significant effect of hormonal changes on sleep in women.