Pregnancy associated osteoporosis

Abstract

We have identified 35 women who have developed osteoporosis during or shortly after pregnancy and in only six of them could a recognized underlying cause be suggested. These findings would suggest that idiopathic osteoporosis associated with pregnancy may be more common than the current literature suggests. The higher prevalence of fractures in the mothers of our population compared to controls raises the question of a possible associated genetic factor in the aetiology of this condition.

Pregnancy-Associated Osteoporosis: Does the Skeleton Recover?

“…Low bone density, initially shown by single photon absorptiometry of the distal radius, was still present 10 years later and the BMD of the offspring of these women (measured by DXA) was also low at the ages of 11 and 13 years. This led the authors to suggest that osteoporosis associated with pregnancy should not be regarded as a transient process and may be familial [12]; this view is supported by previous work which showed a higher prevalence of adult-related fractures in mothers of some subjects with pregnancy-associated osteoporosis [1]. Although the spine and hip are the areas where fractures most often occur in pregnancy-associated osteoporosis, an insufficiency fracture in the sacrum in a vitamin-D-deficient woman has been reported [13].…”

“…Reluctance to perform invasive or radiographic investigation during pregnancy means that little is known about its effects on the skeleton [3]. Lack of bone density measurements before a first, or subsequent, pregnancy also means that the significance of a low bone mineral density (BMD) or osteoporotic fracture in late pregnancy or after delivery is unknown [1,3]. Importantly, we do not know whether osteoporotic fractures during pregnancy reflect architectural collapse of a preexisting fragile skeleton, or whether the pregnancy itself largely contributes to the bone loss.…”

“…Osteoporosis in pregnancy is a rare and mysterious disease [1,2]. Reluctance to perform invasive or radiographic investigation during pregnancy means that little is known about its effects on the skeleton [3].…”

Osteoporose und Mehrlingsgravidität – ein Erfahrungsbericht mit positivem Ausgang

“…Die schwangerschaftsassoziierte Osteoporose ist ein seltenes, möglicherweise aber auch nicht häufig genug diagnostiziertes [7] Ereignis, wobei nach dem heutigen Verständnis der Pathophysiologie der Osteoporose und der Calciumhomöostase in der Schwangerschaft meist davon ausgegangen wird, dass in der überwiegenden Zahl der Fäl-le die Schwangerschaft zur Demaskierung einer bereits vorbestehenden Osteoporose führt [31]. Fälle, in denen es im Schwangerschaftsverlauf zu drastischen Knochenmasseabnahmen kam, sind nicht beschrieben worden, was aber vor allen Dingen darauf beruht, dass von den Schwangeren keine Knochendichtemessungen vor Beginn der Schwangerschaft vorlagen.…”

Successful neridronate therapy in pregnancy-associated osteoporosis

“…The mechanism by which pregnancy determines demineralisation has not yet been fully elucidated. Risk factors are: low peak bone mass, low body weight, inadequate calcium intake during pregnancy, smoking, corticosteroid therapy, pregnancy during adolescence, low serum 25-OH vitamin D levels, twin pregnancies, treatment with heparin during pregnancy (3). The associated increment of bone turnover during pregnancy determines accelerated demineralisation, particularly in the trabecular bone, with consequent increase of the possibility of vertebral fractures (4).…”