The association of restless leg syndrome with sleep quality, depression symptoms, and quality of life in pregnancy: A systematic review and meta-analysis.

OBJECTIVES

Restless legs syndrome (RLS) is a prevalent neurological disorder during pregnancy, contributing to maternal discomfort, sleep disturbances, depression, and reduced quality of life. However, robust evidence on how RLS relates to maternal health outcomes remains limited. This study aimed to systematically quantify the relationships between RLS and sleep quality, depression, and quality of life in pregnant women.

METHODS

A systematic review and meta-analysis were conducted, including studies from PubMed, Web of Science, CINAHL, Cochrane Library, and EMBASE up to October 2025. Methodological quality was assessed using the Newcastle Ottawa Scale.

RESULTS

Sixteen studies including 14,701 pregnant women from diverse countries across Asia, Europe, and the Americas met the inclusion criteria, providing data on pregnant women with RLS. Meta-analyses revealed that RLS was significantly associated with worse sleep quality, with increased sleep disturbances (mean difference [MD] = 2.93; 95% CI: 1.66 - 4.19, p < 0.01; I2 = 94%), and greater daytime sleepness (MD= 2.09; 95% CI: 1.24 - 2.93, p < 0.01;I2 = 87%). RLS nearly doubled the likelihood of depression in pregnant women (pooled odds ratio [OR] = 1.94, 95% CI: 1.55 - 2.48, P=0.63; I2=0%). Poor sleep quality and depression were associated with lower quality of life, with significant decrease in scores (standardized mean difference [SMD] =-1.93; 95% CI: -3.57 to -0.3, p < 0.01; I2 = 98%).

CONCLUSION

Pregnant women with restless legs syndrome (RLS) exhibited a significant association between poorer sleep quality, increased depression risk, and diminished quality of life. Recognizing and managing RLS in pregnancy may be crucial to improving maternal health outcomes.