Restless Leg Symptoms in Pregnancy and Gestational Hypertensive Disorders


PURPOSE: Restless legs syndrome (RLS), is a commonly occurring neurologic disorder that may affect up to a third of women during pregnancy. As RLS has been associated with an increased sympathetic tone in the non-pregnant population, we sought to examine whether RLS symptoms were associated with a higher prevalence of gestational hypertensive disorders (GHD). METHODS: We analyzed data from a cross-sectional survey of 1,000 women in the immediate postpartum. The women were surveyed using one question on a five point Likert scale on how frequently {0=none, 1= rarely (<1 times/week), 2 = sometimes (1-2 times/week), 3 =frequently (3-4 times/week) and 4=always (5-7 times/week)} they had “experienced jumpy or jerky leg movements” in the last 3 months of pregnancy. Clinical charts were also reviewed. We compared subjects who “always” experienced RLS to the rest, and reported odds ratio (OR) with 95% confidence intervals (CI). RESULTS: The mean (±SD) age, pre-pregnancy BMI and BMI at delivery were 29 (±6.1) years, 26.1 (±6.2) Kg/m2 and 32 (6.3) Kg/m2 respectively. The prevalence of jumpy/jerky legs was 35.5% with the following distribution on a Likert scale: Score 1=6.4%; 2=10.2%; 3=8.1%; and 4=10.8%. Prevalence of hypertension in pregnancy was 11.2%; chronic hypertension [cHTN], 2.1%; pregnancy induced hypertension [PIH], 9.5%; and pre-eclampsia [PET], 4.5%. Subjects who reported “always” having sensations of jumpy or jerky legs were 3.5 times (OR, 3.5; 95%CI, 1.3-9.1, p<0.012), 1.35 times (95%CI 0.73-2.52, P<0.343) and 2.16 times (95%CI 1.01 -4.62, p<0.047) more likely to have cHTN, PIH and PET, respectively, than those reporting no or less frequent RLS symptoms. CONCLUSIONS: A higher frequency of RLS symptoms during pregnancy is associated with a higher likelihood of cHTN and GHD. CLINICAL IMPLICATIONS: Our study analysis was limited by the use of a single question for the diagnosis of RLS, increasing the sensitivity at the expense of specificity, but is certainly hypothesis generating regarding a true association of the two disorders. Prospective studies using validated criteria are needed.

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