Interventions for leg cramps in pregnancy

 

Abstract

Background

Many women experience leg cramps in pregnancy. They become more common as pregnancy progresses and are especially troublesome at night.

Objectives

The objective of this review was to assess methods of preventing and treating leg cramps in pregnancy.

Search methods

We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (October 2001). We updated this search on 4 July 2011 and added the results to the awaiting classification section.

Selection criteria

Randomised trials of treatments for leg cramps in pregnancy.

Data collection and analysis

Trial quality was assessed and data were extracted independently by two reviewers.

Main results

Five trials involving 352 women were included. The trials were of moderate quality. The only placebo-controlled trial of calcium treatment showed no evidence of benefit. Trials comparing sodium chloride with placebo (odds ratio 0.54, 95% confidence interval 0.23 to 1.29) and calcium with sodium chloride (odds ratio 1.23, 95% confidence intervals 0.47 to 3.27 ) showed no evidence of benefit. Placebo controlled trials of multivitamin with mineral supplements (odds ratio 0.23, 95% confidence intervals 0.05 to 1.01) and magnesium (odds ratio 0.18, 95% confidence intervals 0.05 to 0.60) provided some suggestion of benefit.

Authors' conclusions

The evidence that calcium reduces cramp is weak and seems to depend on placebo effect. The evidence for sodium chloride is stronger but the results of the sodium chloride trial may no longer be relevant because of dietary changes which include an increased sodium intake in the general population. It is not possible to recommend multivitamins with mineral supplementation, as it is not clear which ingredient, if any, is helping. If a woman finds cramp troublesome in pregnancy, the best evidence is for magnesium lactate or citrate taken as 5mmol in the morning and 10mmol in the evening.

[Note: The five citations in the awaiting classification section of the review may alter the conclusions of the review once assessed.]

 

Plain language summary

Interventions for leg cramps in pregnancy

Sodium supplements may decrease the number of cramp attacks experienced by women in pregnancy but the effect is slight. Calcium is of no benefit. The evidence of benefit for magnesium is stronger. Multivitamin and mineral supplements also seem to help but the relevance of this is unclear as the preparation used contained twelve separate constituents and it is not possible to discover which of these was effective, or indeed if there was synergy between constituents. There is a theoretical risk that sodium supplementation could raise blood pressure. It is unlikely that magnesium supplementation would be harmful at the suggested doses.

 

摘要

背景

懷孕腳抽筋之介入

許多婦女在懷孕時發生腳抽筋，當懷孕越到後期時越普遍，特別是晚上時更是令人困擾

目標

此回顧之目標是評估懷孕時腳抽筋的預防和治療方法

搜尋策略

我們搜尋Cochrane Pregnancy和Childbirth Group trials register (2001年10月)

選擇標準

懷孕時腳抽筋的治療之隨機試驗

資料收集與分析

由2位回顧者獨立評估試驗品質和摘錄資料

主要結論

納入5篇試驗、352名婦女。這些試驗品質中等。唯一的鈣治療之安慰劑控制試驗顯示，並無關於助益之證據。比較氯化鈉和安慰劑的試驗(odds ratio為0.54, 95% CI為0.23 – 1.29)、比較鈣和氯化鈉(odds ratio為1.23, 95% CI為0.47 – 3.27)也顯示無關於助益之證據。綜合維他命和礦物質補充品(odds ratio為0.23, 95% CI為0.05 – 1.01)和鎂(odds ratio為0.18, 95% CI為0.05 – 0.60)的安慰劑控制試驗，提出一些有助益的看法

作者結論

鈣減少抽筋的證據薄弱，似乎只是安慰劑效應。氯化鈉的證據較強些，但是氯化鈉的試驗結果不再相關，近年來因為飲食改變，一般人的鈉攝取量增加。不可能建議綜合維他命和礦物質補充品，因為不清楚哪種成分有幫助。如果婦女在懷孕時有抽筋之困擾，最佳證據有效的是早晨時使用5mmol、和傍晚時使用10mmol的 agnesium lactate或magnesium citrate

翻譯人

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌

總結

懷孕腳抽筋之介入。 鈉補充品可能會減少懷孕婦女的抽筋次數，但是效果輕微。鈣沒有幫助。鎂的助益效果之證據比較強烈。綜合維他命和礦物質補充品似乎也有幫助，但是相關性並不清楚，因為含有12種不同成分，無法確認是哪一種產生效果，或者是成分之間的協同效果所致。鈉補充品在理論上有會增加血壓的風險，鎂補充品在建議劑量時不太可能有傷害