title: Pre-pregnancy restless legs syndrome (Willis-Ekbom Disease) is associated with perinatal depression.
abstract: OBJECTIVE
  Both restless legs syndrome ([RLS], also known as Willis-Ekbom Disease [WED]) and depression are common during pregnancy. However, no prior studies have assessed if pregnant women with RLS have an elevated risk of depression during and/or after pregnancy.
  
  
  METHODS
  1,428 women who were pregnant in gestational week 16-17 were asked to participate in a longitudinal survey. They were followed by web-based questionnaires in gestational week 17 and 32, and 6 weeks after delivery. Data were also retrieved from prenatal and birth records. Two different sets of criteria were used to examine the prevalence of RLS in the cohort (International Restless Legs Syndrome Society Group standard criteria and the later developed CH-RLSQ11 questionnaire). The latter questionnaire attempts to exclude those with common "mimics" of RLS.
  
  
  RESULTS
  Adjusted odds ratio for depression in gestational week 17, 32, and postpartum week 6 in relation to pre-pregnancy RLS onset and moderate to severe symptom severity were 4.74 (2.30 - 9.76), 3.67 (1.85 - 7.28), and 2.58 (1.28 - 5.21), respectively. No significant associations were seen in pregnant women with de novo RLS during pregnancy. When using the standard diagnostic RLS criteria and frequency of symptoms more than 2-3 days per week, the prevalence of RLS was 12.3%. With the CH-RLSQ11 questionnaire and the same threshold for frequency of symptoms the prevalence was 6.5%.
  
  
  CONCLUSIONS
  Women with RLS onset before pregnancy with moderate or severe symptoms had an increased risk of both antenatal and postnatal depression. The self-reported prevalence of RLS during pregnancy is lower when a questionnaire dealing with "mimics" is used.
authors.affiliation: Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden ; Center for Clinical Research Dalarna, Falun, Sweden.
authors.forename: Jan
authors.initials: J
authors.lastname: Wesström
authors.affiliation: Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
authors.forename: Alkistis
authors.initials: A
authors.lastname: Skalkidou
authors.affiliation: Sleep and Epilepsy Centre, Neurocenter (EOC) of Southern Switzerland, Civic Hospital, Lugano, Switzerland.
authors.forename: Mauro
authors.initials: M
authors.lastname: Manconi
authors.affiliation: Sleep and Epilepsy Centre, Neurocenter (EOC) of Southern Switzerland, Civic Hospital, Lugano, Switzerland.
authors.forename: Stephany
authors.initials: S
authors.lastname: Fulda
authors.affiliation: Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
authors.forename: Inger
authors.initials: I
authors.lastname: Sundström-Poromaa
mesh_terms: D000328:Adult; D019052:Depression, Postpartum / Q000209:etiology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000523:psychology; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012148:Restless Legs Syndrome / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology
keywords: depression; pregnancy; restless legs syndrome