A prospective study of Willis-Ekbom disease/restless legs syndrome during and after pregnancy

Objectives: Willis–Ekbom disease/restless legs syndrome (WED/RLS) is the most common sleep-relatedmovement disorder in pregnancy. We designed a prospective longitudinal study to investigate the cor-relates of WED/RLS during and after pregnancy.Design: A total of 138 pregnant women with WED/RLS and a control group of 251 age-matched preg-nant women were enrolled prospectively. A questionnaire was administered during a face-to-face interviewat first evaluation during pregnancy and three months after delivery.Results: Among all women in the first trimester, 15.6% were diagnosed with WED/RLS, whereas 32.8%of those in the second trimester and 38.8% of those in the third trimester were diagnosed with WED/RLS (p = 0.032). In regression analysis, later gestational age [p < 0.001; odds ratio (OR) 1.054] and previoushistory of WED/RLS (p = 0.001; OR 2.795) were positively correlated with the presence of WED/RLS, whileferritin levels (p = 0.001; OR 0.956) were negatively correlated with the presence of WED/RLS. Ferritinlevels were also negatively correlated with the International RLS Study Group severity index (p = 0.041).Forty-eight patients (34.8%) experienced WED/RLS symptomatology after delivery. The ferritin levels werelower, and the mean number of pregnancies was higher, in women with residual WED/RLS (p = 0.008).Conclusion: Our survey showed that WED/RLS was more common in the second and third trimesters.Emergence of WED/RLS during the second trimester was strongly associated with residual WED/RLS. Lowerferritin levels were associated with both WED/RLS in pregnancy and residual WED/RLS after delivery. Ahigher number of pregnancies were also associated with a greater likelihood of having residual WED/RLS after delivery.