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

Restless legs syndrome (RLS) is known as one of the most common movement disorders during pregnancy, which is most aggravated in the third trimester of pregnancy and can affect up to one-third of pregnant women.

This study intends to determine the total prevalence of RLS during pregnancy through a systematic review and meta-analysis.

The present study was conducted using a systematic review approach based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search for relevant studies was performed in the Scopus, Web of Science (WOS), ScienceDirect, and Medline databases using keywords related to RLS and pregnancy. Following data extraction, the necessary statistical analyses were conducted using the random-effects model and performed with the second version of the Comprehensive Meta-Analysis software.

In the final 35 studies, a total of 56,989 individuals were examined. Due to the heterogeneity observed based on the related tests (I²: 99.1%), a random-effects model was used to synthesize the results. Publication bias was assessed using the Egger's test, which indicated no significant bias in the final results the pooled results, the prevalence of RLS in pregnant women was calculated to be 21.9% (CI: 17.3% - 27.4% P ≤ 0.001). the prevalence of RLS in pregnant women in Asia was calculated to be 19.2% (effect size: 19.2%, CI 95% 12.9-27.6, P ≤ 0.001). Furthermore, the prevalence of RLS in Europe (effect size: 22.4%, CI 95% 17.2-28.6, P ≤ 0.001), America (effect size: 19.9%, CI 95% 12.6-29.9, P ≤ 0.001), and Africa (effect size: 58.1%, CI 95% 54.4-61.8, P ≤ 0.001).

This study reveals a global prevalence of 21.9% for RLS among pregnant women. The subgroup analysis further highlights significant regional variation in RLS prevalence, with Africa exhibiting the highest rate at 58.1%, followed by Europe at 22.4%, the Americas at 19.9%, and Asia at 19.2%. These findings underscore the impact of geographical, cultural, and possibly environmental factors on the manifestation of RLS in pregnant women. Such variability calls for further research to explore the underlying causes of these differences, particularly in relation to genetic, nutritional, and healthcare access factors.