Interventions for leg cramps in pregnancy

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. To assess the effectiveness and safety of different interventions for treating leg cramps in pregnancy. We searched the Cochran...

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Bibliographic Details
Published in:Cochrane database of systematic reviews 2015-08 (8), p.CD010655
Main Authors: Zhou, Kunyan, West, Helen M, Zhang, Jing, Xu, Liangzhi, Li, Wenjuan
Format: Article
Language:English
Subjects:
Administration, Oral
Adult
Ascorbic Acid - administration & dosage
Calcium - administration & dosage
Female
Humans
Leg
Magnesium - administration & dosage
Muscle Cramp - therapy
Pain Management - methods
Pregnancy
Pregnancy Complications - therapy
Randomized Controlled Trials as Topic
Vitamin B Complex - administration & dosage
Vitamins - administration & dosage
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Summary: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. To assess the effectiveness and safety of different interventions for treating leg cramps in pregnancy. We searched the Cochrane Pregnancy and Childbirth Group's Register (31 March 2015) and reference lists of retrieved studies. Randomised controlled trials (RCTs) of any intervention (drug, electrolyte, vitamin or non-drug therapies) for treatment of leg cramps in pregnancy compared with placebo, no treatment or other treatment. Quinine was excluded for its known adverse effects (teratogenicity). Cluster-RCTS were considered for inclusion. Quasi-RCTs and cross-over studies were excluded. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. We included six studies (390 women). Four trials compared oral magnesium with placebo/no treatment, two compared oral calcium with no treatment, one compared oral vitamin B versus no treatment, and one compared oral calcium with oral vitamin C. Two of the trials were well-conducted and reported, the other four had design limitations. The process of random allocation was sub-optimal in three studies, and blinding was not attempted in two. Outcomes were reported in different ways, precluding the use of meta-analysis and limiting the strength of our conclusions.The 'no treatment' group in one four-arm trial has been used as the comparison group for the composite outcome (intensity and frequency of leg cramps) in magnesium, calcium, and vitamin B versus no treatment. This gives it disproportionate weight in the overall analysis, thus interpretation of these results should be cautious. Oral magnesium versus placebo/no treatmentMagnesium (taken orally for two to four weeks) did not consistently reduce the frequency of leg cramps compared with placebo or no treatment. Outcomes that showed differences were: frequency of leg cramps after treatment: never, and twice a week (risk ratio (RR) 5.66, 95% confidence interval (CI) 1.35 to 23.68, one trial, 69 women, evidence graded low; RR 0.29, 95% CI 0.11 to 0.80, one trial, 69 women), and frequency of leg cramps: 50% reduction in number of leg cramps after treatment (RR 1.42, 95% CI 1.09 to 1.86, one trial, 86 women, evidence graded low). The outcomes that showed no difference were: frequency of leg cramps during two weeks of treatment (mean
ISSN:1469-493X
DOI:10.1002/14651858.CD010655.pub2