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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 emerging data indicate that RLS/WED is associated with increased rates of gestational hypertension, preeclampsia, cesarean delivery, and depressed mood [1-5].

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 [6-8]. 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 [6].

The majority of cases are of new onset during pregnancy, with preexisting RLS/WED accounting for 4 to 33 percent of cases [1,7,9-13]. 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 [9,12,14].


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Literature review current through: May 2017. | This topic last updated: May 12, 2017.
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