Interventions for leg cramps in pregnancy

Area of Science:

• Obstetrics and Gynecology
• Pharmacology
• Evidence-Based Medicine

Background:

• Leg cramps are a frequent complaint during pregnancy.
• Existing treatments include drug, electrolyte, vitamin, and non-drug therapies.
• This review is an update of a 2015 Cochrane Review.

Purpose of the Study:

• To evaluate the efficacy and safety of various interventions for leg cramps in pregnant individuals.
• To synthesize evidence from randomized controlled trials (RCTs) on treatment effectiveness.

Main Methods:

• Searched multiple trial registries and databases up to September 2019.
• Included RCTs comparing interventions against placebo, no treatment, or other treatments.
• Excluded quinine due to known adverse effects; quasi-RCTs and cross-over studies were also excluded.

Main Results:

• Eight small studies (576 women) were included, primarily assessing oral magnesium, calcium, and vitamin B.
• Evidence certainty was low or very-low due to study limitations and heterogeneity in outcome reporting, precluding meta-analysis.
• Results for magnesium, calcium, and vitamin D showed inconsistent effects on cramp frequency, intensity, and duration, with limited data on adverse events.

Conclusions:

• The effectiveness of interventions for pregnancy-related leg cramps is currently unclear.
• Significant limitations in study design, small sample sizes, and inconsistent outcome reporting hinder definitive conclusions.
• Development of a core outcome set is recommended for future research to improve evidence quality and assess safety.