Restless Legs Syndrome

INFORMATION FOR WOMEN WHO HAVE RESTLESS LEGS SYNDROME DURING PREGNANCY OR BREASTFEEDING

The information provided below is for readers based in the United States of America. Readers outside of the United States of America should seek the information from local sources.

What is restless legs syndrome?

Also known as Willis-Ekbom disease (WED), restless legs syndrome (RLS) is a disorder of sensation and movement whose main feature is unpleasant sensations that give you a strong urge to move your legs. Typically, the symptoms occur while you are resting, but moving your legs makes you feel better, and generally, the symptoms are worse in the evening than during the rest of the day, possibly because there are more distractions during the day.

How common is RLS during pregnancy?

The prevalence of RLS in women is twice that in men and has been reported to affect 2.9 to 32 percent of pregnancies, depending on the criteria for RLS diagnosis are applied in the reports.

How is RLS diagnosed?

Diagnosis of RLS depends greatly on a careful history, and is made based whether you have the following symptoms: An urge to move your legs that usually is accompanied by unpleasant sensations of leg tingling or strange sensations; moving your legs relieves the unpleasant sensations; your symptoms are worse when you are resting, and at night, and are relieved partially by activity. Additionally, the presence of any of the following can support the diagnosis: RLS in your family history; you respond well to medications called dopaminergic agents; you experience sleep disturbances with periodic limb movements as you sleep (occurs in 85 percent of people with RLS).

Does RLS cause problems during pregnancy?

RLS can interfere with your ability to get quality sleep. Additionally, the presence of RLS, suggests that you may be deficient in certain nutrients, such as iron or folate, which can lead to anemia.

Does RLS during pregnancy cause problems for the baby?

RLS is not directly harmful to the developing baby. However, it can result from underlying hormonal or nutritional problems, including inadequate folate levels, which can lead to a category of birth defects called neural tube defects.

What to consider about taking medications when you are pregnant:

  • The risks to yourself and your baby if you do not treat the RLS
  • The risks and benefits of each medication you use when you are pregnant
  • The risks and benefits of each medication you use when you are breastfeeding

What should I know about using medication to treat RLS during pregnancy?

Medications given for RLS include iron supplements, which are not harmful during pregnancy (in fact, they are given often to pregnant women without RLS simply to prevent iron deficiency anemia) and a group of drugs called dopaminergic agents. Dopaminergic agents are grouped broadly into ergot derivatives (bromocriptine, cabergoline) and non-ergot derivatives. While ergot derivatives can be harmful to the developing baby, the non-ergot derivatives (pramipexole, ropinirole, levodopa, rotigotine) are not known to be harmful, so they are considered safe on the basis of the benefit outweighing the risk. Benzodiazepine drugs also are used to relieve RLS symptoms, particularly a drug called clonazepam. While this drug does not cause major malformations, there is some risk of minor malformations, such as a cleft lip appearing in the newborn. RLS outside of pregnancy also is treated with opioid drugs, but these are best avoided in pregnant women as evidence has been mounting that they can indeed harm the developing baby when used on a long-term basis. As a last choice treatment in pregnancy, certain anti-epileptic drugs (gabapentin, carbamazepine, oxcarbazepine) can be considered.

Who should NOT stop taking medication for RLS during pregnancy?

If your symptoms cause you extreme distress, and the medications that you have tried are effective, you are better off continuing with the treatment.

What should I know about choosing a medication for RLS during pregnancy?

You may find Pregistrys expert reports about the individual medications to treat RLS  here. Additional information can also be found in the sources listed at the end of this report.

What should I know about taking a medication for my RLS when I am breastfeeding?

In 97 percent of cases, RLS subsides within a few days after delivery, in which case there is no issue of medication during breastfeeding.

What alternative therapies besides medications can I use to treat my RLS during pregnancy?

Some women can get relief by engaging in activities that promote mental alertness, such as playing chess or doing crossword puzzles. Abstaining from caffeine also may help.

What can I do for myself and my baby when I have RLS during pregnancy?

Be assured that in all likelihood your symptoms will resolve after you deliver.

Resources for RLS in pregnancy:

For more information about RLS during and after pregnancy, contact http://www.womenshealth.gov/ (800-994-9662 [TDD: 888-220-5446]) or read the following articles:

 

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General information

It is very common for women to worry about having a miscarriage or giving birth to a child with a birth defect while they are pregnant. Many decisions that women make about their health during pregnancy are made with these concerns in mind.

For many women these concerns are very real. As many as 1 in 5 pregnancies end in a miscarriage, and 1 in 33 babies are born with a birth defect. These rates are considered the background population risk, which means they do not take into consideration anything about the health of the mom, the medications she is taking, or the family history of the mom or the baby’s dad. A number of different things can increase these risks, including taking certain medications during pregnancy.

It is known that most medications, including over-the-counter medications, taken during pregnancy do get passed on to the baby. Fortunately, most medicines are not harmful to the baby and can be safely taken during pregnancy. But there are some that are known to be harmful to a baby’s normal development and growth, especially when they are taken during certain times of the pregnancy. Because of this, it is important to talk with your doctor or midwife about any medications you are taking, ideally before you even try to get pregnant.

If a doctor other than the one caring for your pregnancy recommends that you start a new medicine while you are pregnant, it is important that you let them know you are pregnant.

If you do need to take a new medication while pregnant, it is important to discuss the possible risks the medicine may pose on your pregnancy with your doctor or midwife. They can help you understand the benefits and the risks of taking the medicine.

Ultimately, the decision to start, stop, or change medications during pregnancy is up to you to make, along with input from your doctor or midwife. If you do take medications during pregnancy, be sure to keep track of all the medications you are taking.


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