Neutrophil­to­lymphocyte ratio as a marker of inflammation in restless legs syndrome during pregnancy.

PURPOSE: The pregnancy is accepted as an independent risk factor for restless legs syndrome/Willis-Ekbom disease (RLS/WED). The neutrophil-to-lymphocyte ratio (NLR) was recently reported in the pathophysiology of RLS/WED. In this report, we investigated the relationship between the presence of RLS/WED and the levels of NLR in pregnancy. METHODS: We included 268 pregnant women attending routine prenatal visits; 148 women had RLS/WED, and 120 women without RLS/WED were the control group. A pre-formed questionnaire was administered to all participants regarding demographic characteristics, habitual behaviors, detailed medical history and questions about RLS/WED including disease duration, severity, and family history. Laboratory investigations were performed in all participants regarding the complete blood count, NLR, fasting blood glucose, blood urea nitrogen, creatinine, ferritin, and total iron binding capacity. RESULTS: NLR was significantly higher in pregnant women with RLS/WED as compared to those without it (3.9±0.9 versus 3.5±1.1, p=0.039). Smoking was also significantly more common in pregnant women with RLS/WED (p=0.022). NLR significantly increased as the gestational period progressed, even after the adjustments for age, BMI, and smoking (p=0.035). Higher NLR in pregnant women with RLS/WED was especially prominent in the 3rd trimester, although the difference was not significant. CONCLUSION: These results may suggest that an increased inflammation demonstrated by the increased NLR, may, in part, play a role in higher prevalence of RLS/WED in pregnancy, especially in late gestational weeks (Tab. 2, Fig. 1, Ref. 34). Text in PDF www.elis.sk Keywords: neutrophil-to-lymphocyte ratio, restless legs syndrome/Willis-Ekbom disease, pregnancy, inflammation.

The Comparison of Facial Emotion Recognition Ability in Women with and without Premenstrual Syndrome.

Objective: It is emphasized that premenstrual syndrome (PMS) includes affective symptoms, such as depressed mood, anxiety and irritability, all of which may influence the recognition of facial emotion expressions. Also it is known that menstrual cycling may effect facial emotion recognition in healthy females. In the present study, we aimed to investigate how menstrual cycling effects of facial emotion recognition facial emotions in women with and without PMS. . METHODS: Sixty healthy women were included to the study. They were divided two group labeled women with PMS (n=33) and without PMS (n=27), which is accordance with the Premenstrual Assessment Form. Then, The Facial Emotion Recognition Test (56 mixed photos with happy, surprised, fearful, sad, angry, disgusted and neutral facial expressions from Ekman & Friesen's series) was performed on each group in both the luteal and follicular phases. RESULTS: The women with PMS were significantly worse in recognizing sad (p=0.003) and surprised (p=0.019) faces in the luteal phase compared to the follicular phase, whereas women without PMS were significantly worse in recognizing sad faces (p=0.008) in the luteal phase compared to the follicular phase. There were no significant differences between women with and without PMS in either the luteal phases or in the follicular phases according to facial emotion recognition (for each, p>0.05). Conclusion: The women with PMS do not differ from women without PMS in recognizing facial emotions accurately. The low accuracy rate in the recognition of sad and surprised facial emotions in the luteal phase may lead PMS women to have more social problems.

A prospective study of Willis-Ekbom disease/restless legs syndrome during and after pregnancy.

OBJECTIVES: Willis-Ekbom disease/restless legs syndrome (WED/RLS) is the most common sleep-related movement disorder in pregnancy. We designed a prospective longitudinal study to investigate the correlates of WED/RLS during and after pregnancy. DESIGN: A total of 138 pregnant women with WED/RLS and a control group of 251 age-matched pregnant women were enrolled prospectively. A questionnaire was administered during a face-to-face interview at first evaluation during pregnancy and three months after delivery. RESULTS: Among all women in the first trimester, 15.6% were diagnosed with WED/RLS, whereas 32.8% of those in the second trimester and 38.8% of those in the third trimester were diagnosed with WED/RLS (p = 0.032). In regression analysis, later gestational age [p < 0.001; odds ratio (OR) 1.054] and previous history of WED/RLS (p = 0.001; OR 2.795) were positively correlated with the presence of WED/RLS, while ferritin levels (p = 0.001; OR 0.956) were negatively correlated with the presence of WED/RLS. Ferritin levels were also negatively correlated with the International RLS Study Group severity index (p = 0.041). Forty-eight patients (34.8%) experienced WED/RLS symptomatology after delivery. The ferritin levels were lower, and the mean number of pregnancies was higher, in women with residual WED/RLS (p = 0.008). CONCLUSION: Our survey showed that WED/RLS was more common in the second and third trimesters. Emergence of WED/RLS during the second trimester was strongly associated with residual WED/RLS. Lower ferritin levels were associated with both WED/RLS in pregnancy and residual WED/RLS after delivery. A higher number of pregnancies were also associated with a greater likelihood of having residual WED/RLS after delivery.