Sleep in late pregnancy predicts length of labor and type of delivery. Sleep disturbances during pregnancy. Magnesium for the treatment of nocturnal leg cramps: a crossover randomized trial. Does oral magnesium substitution relieve pregnancy-induced leg cramps? Effects of a multivitamin mineral supplement on zinc and copper status during pregnancy Pycnogenol alleviates pain associated with pregnancy. Gabapentin Treatment for Muscle Cramps: An Open-Label Trial [Calcium for the treatment of leg cramps during pregnancy]. Oral magnesium for relief in pregnancy-induced leg cramps: a randomised controlled trial. Calcium and magnesium status in pregnant women. A comparison between treatment with calcium and vitamin C in pregnant women with leg cramps. The effect of oral magnesium substitution on pregnancy-induced leg cramps. Vitamin B supplementation for leg cramps during pregnancy.
OBJECTIVE The purpose of this study was to test the hypothesis that fatigue and sleep disturbance in late pregnancy are associated with labor duration and delivery type . STUDY DESIGN In a prospect i ve observational study of 131 women in their ninth month of pregnancy , objective ( 48-hour wrist actigraphy ) and subjective ( sleep logs and question naires ) measures were used to predict labor outcomes using analysis of variance and logistic regression . RESULTS Controlling for infant birth weight , women who slept less than 6 hours at night had longer labors and were 4.5 times more likely to have cesarean deliveries . Women with severely disrupted sleep had longer labors and were 5.2 times more likely to have cesarean deliveries . Fatigue was unrelated to labor outcomes . CONCLUSION Health care providers should prescribe 8 hours of bed time during pregnancy to assure adequate sleep and should include sleep quantity and quality in prenatal assessment s as potential predictors of labor duration and delivery type OBJECTIVE To assess sleep patterns and prevalence of sleep disturbances during pregnancy . DESIGN Cross-sectional design ; prospect i ve question naire . SETTING Outpatient , private obstetric clinic . PARTICIPANTS 127 consecutive patients , with women evaluated at one of four points in pregnancy , 8 - 12 weeks ( n = 37 ) , 18 - 22 weeks ( n = 28 ) , 25 - 28 weeks ( n = 24 ) , and 35 - 38 weeks ( n = 38 ) . MAIN OUTCOME MEASURE Question naire of sleep habits and sleep disturbances . RESULTS A large percentage of the women experienced sleep disturbances during pregnancy , These problems included frequent night wakings , difficulty falling asleep , and symptoms of sleep apnea . Few differences in sleep patterns were found across pregnancy , although women were found to sleep more and nap more by the end of pregnancy . CONCLUSION Sleep disturbances are common during pregnancy , especially late in pregnancy BACKGROUND Nocturnal leg cramps are a common health problem in the ambulatory setting . Our objective was to evaluate the efficacy of magnesium in the treatment of  nocturnal leg cramps .  METHODS Our study was a crossover r and omized double-blind placebo-controlled trial . We included patients from a large university-based ambulatory clinic in Buenos Aires , Argentina , with at least 6 cramps during the previous month . A total of 93 subjects took part in a 4-week washout period with placebo .  Those who were still eligible ( n = 45 ) were r and omized to receive either ( 1 ) an oral dose of 900 mg magnesium citrate twice daily for 1 month , followed by a matching placebo for 1 month , or ( 2 ) the placebo first , followed by magnesium . Both groups had a 4-week washout period with placebo between each treatment month . Forty-two patients completed the 4-month study . The main outcome was the number of nocturnal leg cramps , and the secondary outcomes were duration , severity , and sleep disorders caused by those cramps . RESULTS There were no significant differences between magnesium and placebo in any of the evaluated outcomes . The mean number of cramps was 11.1 ( st and ard deviation [ SD ] + /- 7.3 ) for placebo versus 11.8 ( SD + /- 7.6 ) for magnesium ( P = .59 ) . We observed a significant period-effect bias : All patients improved over time regardless of the treatment sequence they received . CONCLUSIONS Magnesium was not effective for the treatment of nocturnal leg cramps . The period-effect bias probably occurred because of a combination of the natural history of this condition , a regression to the mean , and a true placebo effect OBJECTIVE Our aim was to assess the effect of 360 mg magnesium oral substitution daily among pregnant women suffering from leg cramps in pregnancy , defined as painful cramps different from restless legs symptoms . STUDY DESIGN In a double blind r and omised controlled trial healthy pregnant women between 18 and 36 weeks of pregnancy suffering from painful leg cramps , at least twice a week , were invited to participate . Forty-five women were enrolled initially , 38 completed the treatment and were treated during 2 weeks with either magnesium ( 360mg=15mmol magnesium lactate and magnesium citrate , Nycoplus Magnesium ) , or placebo tablets . Serum magnesium and calcium were investigated together with urine magnesium and magnesium-creatinin ratio on day 1 and day 15 . Frequency and intensity of leg cramps were recorded . The study was powered to detect a 50 % reduction in leg cramps . RESULTS Registration of pain frequency and intensity during the two study weeks demonstrated no significant differences between the two groups . Mean number and intensity of cramps were 9.5 ( S.D. 5.1 ) and 13.2 ( S.D. 6.5 ) in the magnesium group , compared to 7.7 ( S.D. 4.7 ) and 11.4 ( S.D. 8.5 ) in the placebo group . Baseline magnesium levels were 0.77 and 0.74mmol/L in the magnesium group and the placebo group , respectively No significant differences between the two groups , or within the groups , were found when comparing serum values of serum magnesium and total calcium at inclusion time and at the end of the treatment . There was a statistically significant increase in magnesium excretion in the magnesium treatment group ( p<0.01 ) . The number of dropouts was two in the treatment group and five in the control group . CONCLUSIONS No significant effect on frequency or intensity of leg cramps in pregnant women of magnesium treatment with 360 mg daily could be detected in this trial The effect of a multivitamin-mineral supplement was investigated during pregnancy according to a double-blind protocol by determining zinc and copper in maternal plasma , mononuclear and polynuclear zinc and copper at the third , sixth , eighth , and ninth months of gestation . The subjects were supplemented from the first trimester until delivery . A significant decrease was observed in plasma zinc that varied from 11.5 μmol/L to 10.8 μmol/L in the supplemented group ( n=29 ) and from 11 μmol/L to 10 μmol/L in the placebo group ( n=33 ) at 3 and 9 mo of gestation , respectively . In contrast , plasma copper levels increased in a way depending upon the stage of gestation in both groups : from 24.7 to 28.2 μmol/L in the treated group and from 24.9 to 30.9 μmol/L in the placebo group at 3 and 9 mo of gestation , respectively , but the difference was only significant in the placebo group . No difference between groups was observed in mononuclear and polynuclear zinc or copper levels . These trace elements were also determined in cord blood at delivery . There were no statistically significant differences in zinc and copper concentration found in placebo group and supplemented group . Finally , the beneficial effect of supplementation on muscular cramps and appearance of vergetures was noted The effect of Pycnogenol was studied in women in the third trimester of pregnancy , complaining of lower back pain , hip joint pain , pelvic pain ( pain in the inguinal region ) , pain due to varices or calf cramps . The women were supplemented with Pycnogenol at a dose of 30 mg/day without any other therapy . Alleviation of pain was evaluated by pain scores until delivery . A significant reduction of pain could be obtained compared with the control group , where no decrease in pain scores in any symptoms was reported . No unwanted effects were observed in the Pycnogenol group . These results indicate the potential of Pycnogenol to reduce pain associated with pregnancy To evaluate the efficacy and safety of gabapentin in the treatment of  muscle cramps , we engaged an open-label trial with a group of 30 patients with frequent ( > 5 cramps/week ) , stable , long-lasting cramps , associated with different diseases .  Gabapentin was effective in reducing the frequency and severity of muscle cramps and associated sleep disturbances ( clinical outcome measures ) within the first 2 weeks of medication at 600 mg/d . At the 1 month control ( mean dosage , 825 ± 35 mg ) , almost every patient had responded to treatment and two thirds experienced a total remission of symptoms . After 3 months of therapy ( mean dosage , 892 ± 180 mg ) , cramps disappeared in 100 % of patients and this benefit persisted as long as 6 months . Additionally , we evaluated in 10 patients the Cramps Threshold Frequency ( CTF ) ( neurophysiological outcome measure ) before and during gabapentin treatment . Gabapentin significantly increased the CTF , returning it to normal values . With the limitation of an open-label methodology , our clinical and neurophysiologic experience suggests that a gabapentin dose of 600–1200 mg/d would be helpful in the treatment of muscular cramps In an attempt to evaluate the aetiology and therapy of  leg cramps during pregnancy . patients at an antenatal clinic were treated with calcium or a placebo Leg cramps are common in pregnant women . Currently , there is no st and ard treatment for pregnancy-induced leg cramps . The objective of this study was to evaluate the therapeutic efficacy of oral magnesium in pregnant women with leg cramps . This double-blinded , r and omised , placebo-controlled trial included 86 healthy pregnant women , 14 - 34 weeks of gestation who had leg cramps at least twice per week . The study period was 4 weeks . Eighty women completed the study . Forty-one women were assigned to magnesium bisglycinate chelate ( 300 mg per day ) and 39 women to placebo . Details of leg cramps were recorded before beginning the treatment and the fourth week of study . Outcome measure was the reduction of cramp frequency after treatment and cramp intensity measured by 100-mm visual analogue scale . Fifty per cent reduction of cramp frequency was significantly higher in the magnesium group than the placebo group ( 86.0 % vs. 60.5 % , P=0.007 ) . The 50 % reduction of cramp intensity was also significantly higher in the treatment group than in the placebo group ( 69.8 % vs. 48.8 % , P=0.048 ) . There were no significant differences between the two groups in terms of side effects such as nausea and diarrhoea . These results demonstrated that oral magnesium supplement can improve the frequency and intensity of pregnancy-induced leg cramps . Therefore , oral magnesium may be a treatment option for women suffering from pregnancy-induced leg cramps 60 pregnant women underwent a double blind trial with calcium or ascorbic acid ( 1 g twice daily ) as treatment for leg cramps .  There was no significant difference between the two treatment groups with respect to clinical improvement . In 14 out of 60 patients the symptoms were totally abolished and in another 27 patients the symptoms were significantly decreased by the treatment ( irrespective of drug used ) . In 17 patients the symptoms were unaffected while only two patients experienced an increase in frequency of their leg cramps during therapy . Serum total and ionized calcium concentrations , serum total magnesium and albumin concentrations were determined and were not significantly changed throughout therapy in any of the groups . No biochemical differences were found between the different treatment regimens or between those patients relieved or not relieved of their symptoms . Serum magnesium concentrations were at or just below the lower normal limit ( for non pregnant women ) in treated women and pregnant controls OBJECTIVE Our purpose was to determine whether women with pregnancy-related leg cramps would benefit from oral magnesium supplementation . STUDY DESIGN Seventy-three women with pregnancy-related leg cramps were interviewed about their symptoms in a prospect i ve , double-blind , r and omized trial . Initial serum magnesium levels and diurnal magnesium excretion was determined in 50 % of the patients . Oral magnesium or placebo was given for 3 weeks , after which new interviews and laboratory analyses were performed . RESULTS Serum magnesium levels in these patients were at or below the lower reference limit , as is also often the case in healthy pregnant patients . Oral magnesium substitution decreased leg cramp distress ( p < 0.05 compared with the placebo group , p < 0.001 compared with initial complaints ) , but did not significantly increase serum magnesium levels , excess magnesium being excreted as measured by an increase in urinary magnesium levels ( p < 0.002 ) . CONCLUSION Oral magnesium supplementation seems to be a valuable therapeutic tool in the treatment of pregnancy-related leg cramps Muscle cramps or unintentional painful spasms occur in the lower limbs of about half of all pregnant women mostly during the second half of pregnancy and mostly at night . Different treatment modalities have been suggested but none have been proven to be significantly effective . This study was design ed to compare the effects of different supplementation therapies in Iranian pregnant women . After obtaining written consent 84 pregnant women were r and omly allocated to 4 groups . For a total of 2 weeks Group 1 received 500 mg calcium carbonate tablets ( Tehran Chimie Iran ) once daily ; Group 2 received 7.5 mmol magnesium aspartate ( Magnesiocard ; Verla Germany ) twice daily ; Group 3 received 100 mg of thiamine ( vitamin B/1 ) plus 40 mg of pyridoxine ( vitamin B/6 ) ( Tehran Chimie Iran ) once daily . Group 4 ( the control group ) received no treatment . The results of each treatment were assessed after 4 weeks . ( excerpt
BACKGROUND Leg cramps are a common problem in pregnancy .
Various interventions have been used to treat them , including drug , electrolyte and vitamin therapies , and non-drug therapies .
OBJECTIVES To assess the effectiveness and safety of different interventions for treating  leg cramps in pregnancy .