目的:本研究的目的是在经过验证的诊断工具和全面的文献综述的基础上,根据妊娠3个月和RLS的预测因素,搜索RLS在妊娠中的患病率和严重程度。
方法:横断面描述性研究包括500名没有合并症的孕妇,他们接受了面对面的访谈。年龄,高度,体重,怀孕一周,吸烟,酒精,咖啡因的使用,定期锻炼,和最后一次访问的实验室测试结果都包含在数据中。只有满足RLS诊断标准的女性才会被给予不安腿综合征评定量表。
结果:发现RLS的患病率为29.2%,妊娠晚期的患病率最高(64.4%)。在所有三个月里,低铁蛋白(妊娠早期:p=0.004;妊娠中期:p<0.001;妊娠中期:p<0.001),叶酸(妊娠早期:p=0.001;妊娠中期:p<0.001;妊娠中期:p<0.001),维生素B12(妊娠早期:p=0.003;妊娠中期:p<0.001;妊娠中期:p<0.001),和血红蛋白(妊娠早期:p<0.001;妊娠中期:p<0.001;妊娠晚期:p<0.001)水平与RLS相关。在第二和第三个三个月,低镁(分别为p<0.001和p<0.001)和高肌酐(分别为p=0.027和p<0.001)水平与RLS相关.在妊娠晚期,较高的促甲状腺激素和游离T4水平与RLS相关,但在妊娠早期和中期则不相关(中位数:2.4vs.2.1,p<0.001;中位数:1.5vs.1.2,p<0.001)。在多元回归分析中,年龄(p=0.034,OR:1.060,95%CI:1.005-1.119),当前BMI(p<0.001,OR:1.8884,95%CI:1.597-2.222),受孕前BMI(p<0.001,OR:0.607,95%CI:0.513-0.718),gravida(p<0.001,OR:2.172,95%CI:1.547-3.049),低铁蛋白水平(p<0.001,OR:6.396,95%CI:0.00744-0.010405),低维生素B12(p<0.001,OR:10.347,95%CI:0.00120-0.00176),低叶酸(p<0.001,OR:5.841,95%CI:0.00616-0.01240),受孕前RLS病史(p=0.013,OR:4.963,95%CI:1.402-17.57),和RLS家族史(p<0.001,OR:7.914,95%CI:0.18760-0.31151)被发现是妊娠RLS的预测因素。
结论:怀孕期间需要更多的关注RLS来预防或治疗这种综合征。
OBJECTIVE: The current study aimed to search the prevalence and severity of restless legs syndrome (RLS) in pregnancy according to the three trimesters and predictive factors of RLS in pregnancy based on validated diagnostic tools and a thorough literature review.
METHODS: The cross-sectional descriptive study included 500 pregnant women without comorbidities who were interviewed face-to-face. Age, height, weight, week of pregnancy, smoking, alcohol, caffeine use, regular exercise, and lab test results from the last visit were all included in the data. Only women satisfying the RLS diagnostic criteria were given the Restless Legs Syndrome Rating Scale.
RESULTS: The prevalence of RLS was found to be 29.2% with the highest rate in the third trimester (64.4%). In all trimesters, low ferritin (first trimester: p = 0.004; second trimester: p < 0.001; third trimester: p < 0.001), folic acid (first trimester: p = 0.001; second trimester: p < 0.001; third trimester: p < 0.001), vitamin B12 (first trimester: p = 0.003; second trimester: p < 0.001; third trimester: p < 0.001), and hemoglobin (first trimester: p < 0.001; second trimester: p < 0.001; third trimester: p < 0.001) levels were associated with RLS. In the second and third trimesters, low magnesium (p < 0.001 and p < 0.001, respectively) and high creatinine (p = 0.027 and p < 0.001, respectively) levels were associated with RLS. Higher thyroid-stimulating hormone and free T4 levels were associated with RLS in the third trimester but not in the first and second trimesters (median: 2.4 vs. 2.1, p < 0.001; median: 1.5 vs. 1.2, p < 0.001). In the multivariate regression analysis, age (p = 0.034, OR: 1.060, 95% CI: 1.005-1.119), present BMI (p < 0.001, OR: 1.8884, 95% CI: 1.597-2.222), BMI before conception (p < 0.001, OR: 0.607, 95% CI: 0.513-0.718),
gravida (p < 0.001, OR: 2.172, 95% CI: 1.547-3.049), low ferritin level (p < 0.001, OR: 6.396, 95% CI: 0.00744-0.010405), low vitamin B12 (p < 0.001, OR: 10.347, 95% CI: 0.00120-0.00176), low folate (p < 0.001, OR: 5.841, 95% CI: 0.00616-0.01240), RLS history before conception (p = 0.013, OR: 4.963, 95% CI: 1.402-17.57), and RLS family history (p < 0.001, OR: 7.914, 95% CI: 0.18760-0.31151) were found to be predictive factors for RLS in pregnancy.
CONCLUSIONS: More attention is needed to RLS during pregnancy to prevent or treat this syndrome.