Consensus clinical practice guidelines for the diagnosis and treatment of restless legs syndrome/Willis-Ekbom disease during pregnancy and lactation

Prevalence of restless legs syndrome during pregnancy: A systematic review and meta-analysis

Restless legs syndrome (RLS) is a common sleep disorder that may be associated with pregnancy. Studies have found that the prevalence of RLS among pregnant women ranged from 10 to 34%. Typically, there is complete remission of symptoms soon after parturition; however, in some patients, they may continue postpartum. RLS has been shown to be associated with a number of complications in pregnancy including preeclampsia and increased incidence of Cesarean sections. Although multiple hypotheses have been proposed to explain this association, each individual hypothesis cannot completely explain the whole pathogenesis. Present understanding suggests that a strong family history, low serum iron and ferritin level, and high estrogen level during pregnancy might play important roles. Vitamin D deficiency and calcium metabolism may also play a role. Medical treatment of RLS during pregnancy is difficult and challenging considering the risks to mother and fetus. However, in some cases, the disease may be severe enough to require treatment.

/pdf/restless-legs-syndrome-and-pregnancy-prevalence-possible-q46a05xeeq.pdf

Restless legs syndrome and pregnancy: prevalence, possible pathophysiological mechanisms and treatment.

One of the core symptoms of the menopausal transition is sleep disturbance. Peri-menopausal women often complain of difficulties initiating and/or maintaining sleep with frequent nocturnal and early morning awakenings. Factors that may play a role in this type of insomnia include vasomotor symptoms, changing reproductive hormone levels, circadian rhythm abnormalities, mood disorders, coexistent medical conditions, and lifestyle. Other common sleep problems in this age group, such as obstructive sleep apnea and restless leg syndrome, can also worsen the sleep quality. Exogenous melatonin use reportedly induces drowsiness and sleep and may ameliorate sleep disturbances, including the nocturnal awakenings associated with old age and the menopausal transition. Recently, more potent melatonin analogs (selective melatonin-1 (MT1) and melatonin-2 (MT2) receptor agonists) with prolonged effects and slow-release melatonin preparations have been developed. They were found effective in increasing total sleep time and sleep efficiency as well as in reducing sleep latency in insomnia patients. The purpose of this review is to give an overview on the changes in hormonal status to sleep problems among menopausal and postmenopausal women.

https://www.longdom.org/open-access/sleep-disorders-in-postmenopausal-women-2167-0277-1000212.pdf

Sleep Disorders in Postmenopausal Women

Objective: The purpose of this study was to examine the associations of sleep disturbances during pregnancy with cesarean delivery and preterm birth.Methods: In this prospective study, 688 healthy ...

Sleep disturbances during pregnancy are associated with cesarean delivery and preterm birth.

BACKGROUND: Restless legs syndrome (RLS) is a frequent neurological disorder which predominantly affects women. Pregnancy is one of the most common conditions leading to secondary RLS. Severe symptoms of RLS may lead to complications of pregnancy and/or labor. The aim of this study was to determine the prevalence and characteristics of RLS in pregnant women. METHODS: Women in the third trimester of grav idity filled out a simple questionnaire based on the official diagnostic criteria for RLS. Positive responders were interviewed in order to further characterize their symptoms. Afterwards information on changes in frequency and/or intensity of the symptoms after delivery was obtained by a telephone follow-up. All data were statistically analysed. RESULTS: A total of 300 questionnaires were completed. All 94 RLS-positives met the four diagnostic criteria (31.33%). There was no difference in age, body mass index, or the number of previous pregnancies between RLS-positives and RLS-negatives, but weight gain during pregnancy was significantly higher in RLSpositives. More than 30% of positives had clinically significant symptoms, and 50% reported sleep disturbances. Almost 75% of the cases of RLS were secondary, i.e., symptoms occurred only during pregnancy (with a peak in the third trimester). More complications of pregnancy or labor occurred in women with RLS, but this was only marginally significant. CONCLUSIONS: Our study confirmed the relatively high prevalence of RLS in pregnant women compared with the general population. Although almost threefourths of the symptoms were only transient throughout pregnancy, the impact of the severe symptoms and sleep deprivation on the course of pregnancy and delivery was not negligible. Early detection and adequate treatment of severe RLS are necessary to prevent maternal discomfort and possible health risks. The questionnaire method is a simple, reliable diagnostic tool.

Prevalence and impact of restless legs syndrome in pregnancy.

Aim
To identify characteristic risk factors of preterm birth in Central and Eastern Europe and explore the differences from other developed countries

/pdf/disparities-and-relative-risk-ratio-of-preterm-birth-in-six-2juydn14n7.pdf

Disparities and relative risk ratio of preterm birth in six Central and Eastern European centers.

Ornithine transcarbamylase (OTC) deficiency is the most common inherited metabolic disorder in urea cycles with an incidence of 1:14,000 live births. Pregnancy, childbirth and the postpartum period are considered challenging for women with this hereditary metabolic disorder, with a risk of hyperammonemia, especially in the first week after delivery. In our article, we discuss severe hepatic failure, a pregnancy complication in an OTC deficient patient that has not previously been published. Firstly, our aim is to highlight the need for a strict adherence to the recommendation of the gradual increase of protein intake during pregnancy and the importance of multidisciplinary monitoring of pregnant patients with OTC deficiency. Secondly, we refer to critical postpartum hyperammonemia in patients with this hereditary metabolic disorder.

/pdf/effect-of-ornithine-transcarbamylase-otc-deficiency-on-2eb4ggod.pdf

Effect of Ornithine Transcarbamylase (OTC) Deficiency on Pregnancy and Puerperium

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Papers

Prevalence and impact of restless legs syndrome in pregnancy.

Disparities and relative risk ratio of preterm birth in six Central and Eastern European centers.

Effect of Ornithine Transcarbamylase (OTC) Deficiency on Pregnancy and Puerperium