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Restless legs syndrome/Willis-Ekbom disease during pregnancy and lactation

Daniel L Picchietti, MD
Section Editor
Alon Y Avidan, MD, MPH
Deputy Editor
April F Eichler, MD, MPH


Restless legs syndrome, also known as Willis-Ekbom disease (RLS/WED), is very common during pregnancy, affecting approximately one in five women at some point during the course of their pregnancy. It varies widely in severity, from a minor nuisance in some women to severe, disruptive symptoms in others. Symptoms tend to peak during the third trimester and remit or markedly improve after delivery.

RLS/WED commonly impacts sleep during pregnancy, and accumulating data indicate that RLS/WED symptoms are associated with increased rates of gestational hypertension, preeclampsia, cesarean delivery, excessive daytime sleepiness, poor daytime function, and depressed mood [1-12]. Less robust data suggest that RLS/WED or a history of leg jerking during pregnancy are associated with fetal distress, lower birth weight, prematurity, and obstructive sleep apnea [10,13,14].

This topic will review aspects of the diagnosis and treatment of RLS/WED that are unique to pregnancy. Clinical features, diagnosis, and treatment of RLS/WED in the general population are discussed elsewhere. (See "Clinical features and diagnosis of restless legs syndrome/Willis-Ekbom disease and periodic limb movement disorder in adults" and "Treatment of restless legs syndrome/Willis-Ekbom disease and periodic limb movement disorder in adults" and "Restless legs syndrome/Willis-Ekbom disease and periodic limb movement disorder in children".)


The prevalence of restless legs syndrome/Willis-Ekbom disease (RLS/WED) during pregnancy is two- to threefold higher than the prevalence in the general population [15-17]. RLS/WED affects approximately 15 to 25 percent of pregnant women in Western countries and a somewhat lower proportion in most Asian countries, where general population rates are typically lower [9,15,18].

The majority of cases are of new onset during pregnancy, with preexisting RLS/WED accounting for 4 to 33 percent of cases [1,16,19-23]. Risk factors for RLS/WED during pregnancy include preexisting RLS/WED, a family history of RLS/WED, RLS/WED during a prior pregnancy, and low ferritin [19,22,24,25].

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Literature review current through: Nov 2017. | This topic last updated: Aug 07, 2017.
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