Restless Leg Syndrome and Pregnancy

Abstract

Objective: The purpose of this assessment of the literature was to evaluate the etiology, incidence, risk factors, diagnosis, management, and recurrent risk in a subsequent pregnancy of restless leg syndrome (RLS) in pregnancy.

Methods: Electronic databases (PubMed, Embase, and Web of Science) were searched from January 1980-February 2024. The only limitation was that the articles had to be in English. Studies were selected that examined associations among the etiology, prevalence, risk factors, diagnosis and management of RLS during pregnancy.

Results: A total of 498 articles were identified, 47 of which are the basis of this review. RLS is a common occurrence during pregnancy, occurring in up to one-fourth of all pregnancies. The pathophysiology likely involves brain iron deficiency, hormonal changes of pregnancy, mechanical strain from the growing pregnancy, and stress/insomnia. The prevalence of RLS increases in the later trimesters, with increasing parity, and may have regional variations. Risk factors include a history of RLS and underlying hypertension. Criteria for diagnosis have been established by the RLS Study Group. Management involves lifestyle modifications, behavioral strategies, iron and pharmacologic therapy.

Conclusions: RLS is commonly seen in pregnancy, and the prevalence increases with increasing gestational age. Iron deficiency seems to be a common contributor to RLS. Management involves behavioral/lifestyle modifications, iron therapy, and may involve pharmacological therapy.