Restless legs syndrome triples the risk of perinatal depression in pregnant women

New research found a higher risk of perinatal depression in pregnant women with restless legs syndrome.

Results show that pregnant women with RLS were three times more likely to develop perinatal depression, which involves major depressive episodes during pregnancy or the months after childbirth. They were also two times more likely to develop depressive symptoms. The association was strongest when RLS occurred during the third trimester. The findings remained significant after accounting for factors including age, education, partner status, occupation, number of children, and whether the pregnancy was planned.

We found that pregnant women with restless legs syndrome had about three times the risk of developing perinatal depression. This association was seen for restless legs syndrome identified in the third trimester, but not in the second."

Dr. Kazuhide Tezuka, first author, visiting researcher, department of mental health, University of Tokyo Graduate School of Medicine

The study was published Aug. 31 in the Journal of Clinical Sleep Medicine, the official publication of the American Academy of Sleep Medicine.

Restless legs syndrome is a sleep-related movement disorder characterized by a strong, nearly irresistible urge to move the legs, often accompanied by other uncomfortable sensations felt in the legs. These symptoms begin or worsen during periods of rest or inactivity, are temporarily or totally relieved by movement, and occur exclusively or predominantly in the evening or at night, making it difficult to fall asleep. A recent AASM survey found that 13% of Americans report having been diagnosed with RLS. Previous research also has shown that people with RLS experience depression and anxiety at four times the rate of the general U.S. population, and that RLS commonly occurs during pregnancy.

The study analyzed data from 2,435 pregnant women in Japan with an average age of 30.5 years. Participants completed screening questionnaires for RLS during the second and third trimesters, revealing that 40 women (1.6%) had RLS during the second trimester, and 60 women (3.5%) had RLS in the third trimester. Researchers also tracked major depressive episodes and symptoms through three months postpartum, during which 69 participants developed perinatal depression.

According to the authors, the findings suggest that screening for RLS during pregnancy, particularly in the third trimester, may help identify women at an elevated risk of perinatal depression and support earlier intervention.

"Because restless legs syndrome often develops later in pregnancy, asking about its symptoms again in the third trimester, not just at early prenatal visits, may help healthcare providers identify women at higher risk of perinatal depression," said Tezuka.

The researchers noted that the prevalence of RLS was lower than expected, the number of depression cases among participants with RLS was small, that participants were self-selected volunteers, and that all measures were self-reported. They emphasized that further investigation is needed to determine whether treating RLS can reduce the risk of perinatal depression.