Restless Legs Syndrome In Pregnant Women Research Articles

The effects of restless legs syndrome on sleep and quality of life during pregnancy: a comparative descriptive study

Objective: The study aimed to identify the effects of restless legs syndrome (RLS) on sleep quality and quality of life in pregnant women.Methods: This comparative and descriptive study was conducted with 109 pregnant women between the 24 and 39 weeks of gestation. The presence and severity of RLS were investigated using the International Restless Legs Syndrome Study Group’s Diagnostic Criteria Scale and Severity Rating Scale, and the effects of the syndrome on sleep and quality of life were evaluated. Results: The prevalence of RLS in pregnant women was found to be 47.7%. In the RLS group, 22.0% of the pregnant women had severe RLS symptoms and 20.2% had moderate RLS symptoms. The mean score for Restless Legs Syndrome Severity Rating Scale was determined 20.75±6.38. The mean score for quality of life scale was determined 17.75±3.73 in RLS group and 26.46±2.67 in non-RLS group. Conclusion: The difference between the mean scores for Pittsburgh Sleep Quality Index of the pregnant women with RLS and those without the syndrome was found to be statistically significant. While the mean score for Quality of Life Scale in pregnant women with RLS was lower in general health, physical health and psychological health sub-dimensions, no statistically significant difference was found in social relations and environment sub-dimensions. It is recommended that nurses investigate RLS complaints of pregnant women and include non-pharmacological methods in their nursing practices.

Determination of optimal 25-hydroxyvitamin D cutoff values for the evaluation of restless legs syndrome among pregnant women.

Vitamin D deficiency is associated with restless legs syndrome (RLS). However, a cutoff value for serum 25-hydroxyvitamin D (25[OH]D) level associated with RLS has yet to be clearly determined. We evaluated the association between 25(OH)D and RLS in pregnant women. Data from 203 pregnant women were evaluated using blood samples taken in the third trimester. Liquid chromatography-tandem mass spectrometry and ligand binding assays were used to measure 25(OH)D. RLS was diagnosed based on International Classification of Sleep Disorders, third edition, criteria. The cutoff value for serum 25(OH)D associated with RLS was explored using receiver operating characteristic (ROC) curve and classification and regression tree (CART) analyses. The results of liquid chromatography-tandem mass spectrometry (x) and ligand binding assays (y) for serum 25(OH)D in the RLS (n = 35, 17.2%) and non-RLS (n = 168) groups showed a relationship of y = -2.65 + 0.08x . The RLS group showed lower serum 25(OH)D and folate levels. ROC curve and CART analyses revealed cutoff values of 10-12.7 ng/mL and 6.6-7.2 ng/mL for 25(OH)D and folate, respectively. Of the 5 women with RLS symptoms persisting at a moderate-to-severe level after delivery, 4 had 25(OH)D levels < 10 ng/mL and all had folate levels < 6 ng/mL. Vitamin D and folate deficiency were associated with RLS in pregnant women and may be associated with persistent moderate-to-severe postpartum RLS symptomatology; it is essential to examine associations with RLS while accounting for measurement methods and assay systems. Miyazaki A, Takahashi M, Shuo T, Eto H, Kondo H. Determination of optimal 25-hydroxyvitamin D cutoff values for the evaluation of restless legs syndrome among pregnant women. J Clin Sleep Med. 2023;19(1):73-83.

Prevalence of restless legs syndrome in pregnant women: a systematic review and meta-analysis.

Restless legs syndrome (RLS) is a neurological disorder characterized by sleep disorders, which leads to adverse health consequences in the mother and fetus. Studies have reported different prevalence rates for RLS in pregnant women. This systematic review and meta-analysis aimed to estimate the prevalence of RLS in pregnant women. A literature search was performed via national and international databases, including Scientific Information Database (SID), MagIran, IranMedex, Google Scholar, Science Direct, PubMed, ProQuest, and Scopus. In total, 31 articles were selected without a time limit. The random effects model was used to analyze the data, and the heterogeneity between the studies was examined using the I2 index. The analyses were performed in the Stata software, version 12 and R, version 4. The reviewed studies (n=31) were conducted on a total sample size of 59,151, and the prevalence of RLS in pregnant women was estimated at 21.4% [95% confidence interval CI: 17.7-25.1]. Asia with a prevalence rate of 18.5%, [95% CI: 13.8-23.1] and Europe with a prevalence rate of 25.5%, [95% CI: 19.5-31.6] had the lowest and highest RLS prevalence, respectively. No significant correlations were observed between the prevalence of RLS, publication year of the articles (P=0.972), and participants' age (P=0.202). According to the results, RLS is highly common in pregnant women, and it is essential to identify women with RLS to control and eliminate the adverse consequences of the disorder.

Prevalence and risk factors for restless legs syndrome during pregnancy in a Northern Italian population

The objective of the present study was to investigate the frequency and the risk factors for restless legs syndrome (RLS) during pregnancy in an Italian population rarely studied, in epidemiological studies on the syndrome. A total of 648 women (median age: 35 years; interquartile range: 32–38), who delivered on randomly selected days at the obstetric department of our hospital, were identified.One hundred and thirty-two women (20.4%, 95% confidence interval (CI): 17.3–23.5) met the criteria for a diagnosis of RLS. The odds ratio (OR) of RLS was, in comparison with women aged <35 years, 1.69 (95% CI 1.14–2.51) in women aged ≥35 years. Subjective insufficient sleep (OR: 2.35, 95% CI 1.27–4.35) and difficulty in initiating sleep (OR: 1.73, 95% CI 1.15–2.63) increased the risk of RLS.This study confirms the high frequency of RLS in pregnant women. The risk of the condition was increased in women aged ≥35 years and in the women reporting sleep-wake disturbances during pregnancy.Impact statementWhat is already known on this subject? Restless legs syndrome (RLS), a common neurological, sensorimotor disorder, is two/three times more frequent in pregnant women than in the general population. The prevalence of RLS during pregnancy ranges widely, showing differences among populations.What do the results of this study add? This study adds data about the frequency and the risk factors for RLS during pregnancy in a Northern Italian population, rarely considered in epidemiological studies on the syndrome. Older age and sleep-wake disturbances are the main factors associated with the condition.What are the implications of these findings for clinical practice and/or further research? Screening for RLS might be useful for pregnant women to manage the condition. Further research is needed to investigate and define the potential impact of RLS during pregnancy on foetal and maternal health.

Open-label study of the efficacy and safety of intravenous ferric carboxymaltose in pregnant women with restless legs syndrome

ObjectiveThe objective of this study was to test the efficacy and safety of intravenous ferric carboxymaltose (FCM) in pregnant women with restless legs syndrome (RLS) and iron deficiency or anemia. The open-label pilot study (exploratory) was performed at the University Hospital of Zürich and the Neurocenter of Southern Switzerland (Lugano). Patient and MethodsNineteen women in the third trimester of pregnancy with moderate-to-severe RLS and serum ferritin levels <35 µg/l or hemoglobin (Hb) < 11.0 g/dl were included in the study. RLS was graded according to the International Restless Legs Syndrome (IRLS) Study Group rating scale. All participants had a score of ≥20 or had RLS ≥3 times/week. Based on the Hb levels, 500 or 700 mg of FCM was administered over 20 min. The primary end point was a ≥ 50% reduction in the mean IRLS score one week after FCM infusion. The secondary end points included periodic limb movements (PLMs; assessed using nocturnal foot actigraphy), sleep quality (assessed using the Pittsburgh Sleep Quality Index), and safety. ResultsThe IRLS score decreased from 23 ± 7 (baseline) to 13 ± 7 (P < 0.01), whereas the PLM index decreased from 35 ± 26 (baseline) to 25 ± 20 (P < 0.001). Significant improvement in sleep quality was also reported (P < 0.029), and treatment was well tolerated. Three serious adverse events were reported, but they were considered unrelated to treatment. ConclusionsThese data provide promising evidence on the safety and efficacy of FCM for moderate-to-severe RLS in pregnant women with iron deficiency or anemia. Therefore, a future placebo-controlled study is warranted.

Restless legs syndrome in pregnancy is connected with iron deficiency

ObjectiveAlmost one-third of pregnant women develop symptoms of restless legs syndrome (RLS), which could have a negative impact on quality of life and the course of pregnancy and/or labor. The aim of our study was to determine possible risk factors for developing RLS in pregnant women. MethodsA total of 300 random women in the third trimester of gravidity filled out a simple questionnaire based on the official diagnostic criteria for RLS. Respondents positive for RLS were interviewed to further characterize their symptoms. The parameters of iron metabolism were examined based on blood samples. All data were statistically analyzed. ResultsWe detected significantly lower hemoglobin levels with signs of hypochromic anemia typical of iron deficiency in RLS-positive respondents, although oral iron supplementation was significantly higher in this group. The overall severity of symptoms correlated inversely with hemoglobin level. ConclusionAccording to our results, it appears that serum iron level disturbances play a crucial role in the pathophysiology of secondary RLS in pregnant women.

Restless legs syndrome and hypertension in Chinese pregnant women.

Hypertension is a common complication of pregnancy, and studies show that pregnant women are more likely to suffer from restless legs syndrome (RLS). Pregnant women with hypertension and RLS often experience disrupted sleep patterns because of activation of the nervous system. The present study aimed to clarify the relationship between hypertension and RLS in pregnant women, and their impact on sleep. We enrolled 3,781 pregnant women who were admitted at our hospital for delivery between May 2011 and May 2014. The face-to-face questionnaire used to gather data included the International RLS Study Group criteria for diagnosis, Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and hypertension diagnosis. Depending on the time of occurrence of hypertension, it was divided into two different types: pregnancy-induced hypertension and chronic hypertension in pregnancy. Out of 3,781 patients, 453 fulfilled the diagnostic criteria for RLS and 486 met the diagnostic criteria for hypertension. Among patients with RLS, prophylactic iron supplementation was less frequently taken during pregnancy. Pregnancy-induced hypertension, rather than chronic hypertension in pregnancy, was found to be more frequent in patients with RLS; pregnant women with RLS had higher PSQI and ESS scores than pregnant controls. In our study, RLS was frequent in pregnant women, especially in those without prophylactic iron supplementation. Patients with RLS described more serious sleep disruption and excessive daytime sleepiness (EDS). In addition, pregnancy-induced hypertension was more common in patients with RLS.

Predictors of restless legs syndrome in pregnancy: A hospital based cross sectional survey from Pakistan

Restless legs syndrome (RLS) is more common in pregnant women. The objective of our study was to determine frequency of RLS in pregnant women and predictors of RLS in pregnancy in Pakistan. All pregnant women admitted at The Aga Khan University Hospital for delivery from June to July 2005 were enrolled. Eighty-one of 271 (30%) interviewed women fulfilled the diagnostic criteria of RLS. One hundred seventeen (43%) of the subjects dropped their haemoglobin during the pregnancy. No significant difference in haemoglobin drop was noted between the RLS group and healthy group. On multivariate analysis family history of RLS (OR: 8.43, CI: 2.32–30.57, p value < 0.001), history of RLS in prior pregnancy (OR: 53.74, CI: 6.72–429.8, p value < 0. 001), history of RLS in past even when non-pregnant (OR: 12.91, CI: 3.34–49.87, p value < 0.001) and haemoglobin of 11 g/dL or less (OR: 2.05, CI: 1.04–4.04, p value 0.036) were found to be independent predictors of RLS during pregnancy. Subgroup analysis revealed that family history of RLS (OR: 3.06, CI: 1.2–7.83, p value 0.019) and anemia (OR: 1.89, CI: 0.96–3.71, p value 0.06) were associated with de novo RLS, and family history of RLS (OR: 12.39, CI: 4.45–35.54, p value < 0.001) and multiparity (OR: 6.84, CI: 2.15–21.71, p value 0.001) were predictors of pre-existing RLS.

Pregnancy as a risk factor for restless legs syndrome

Pregnant women have at least two or three times higher risk of experiencing restless legs syndrome (RLS) than the general population. These data come from few epidemiological studies finding an 11–27% prevalence of RLS during pregnancy. Women affected by pre-existing RLS often complain of worsening symptoms during pregnancy. This is usually a benign form of RLS, with the highest degree of severity in the third trimester and a tendency to disappear around delivery. The causes of the association between RLS and pregnancy are unknown. The most debated hypotheses are: metabolic alterations, with particular regard to iron and folate deficiency; hormonal influences related to the increase of prolactin, progesterone and estrogens during late pregnancy; and the changing motor habits and psychological state of pregnant women. The importance of folate and iron supplementation during pregnancy in preventing RLS is unclear. RLS in pregnant women is frequently unrecognized; they are often worried about the symptoms and do not receive an adequate explanation by doctors.

Pregnancy as a risk factor for restless legs syndrome

Pregnant women have at least two or three times higher risk of experiencing restless legs syndrome (RLS) than the general population. These data come from few epidemiological studies finding an 11–27% prevalence of RLS during pregnancy. Women affected by pre-existing RLS often complain of worsening symptoms during pregnancy. This is usually a benign form of RLS, with the highest degree of severity in the third trimester and a tendency to disappear around delivery. The causes of the association between RLS and pregnancy are unknown. The most debated hypotheses are: metabolic alterations, with particular regard to iron and folate deficiency; hormonal influences related to the increase of prolactin, progesterone and estrogens during late pregnancy; and the changing motor habits and psychological state of pregnant women. The importance of folate and iron supplementation during pregnancy in preventing RLS is unclear. RLS in pregnant women is frequently unrecognized; they are often worried about the symptoms and do not receive an adequate explanation by doctors.