Pregnancy-associated osteoporosis: a case-control study

Abstract

Our results indicate that PAO is a heterogeneous, rare but severe disease including a substantial number of fractures with a significant delay from first symptom to diagnose. Increased awareness is warranted to immediately start effective treatment.

Mutational analysis uncovers monogenic bone disorders in women with pregnancy-associated osteoporosis: three novel mutations in LRP5, COL1A1, and COL1A2

“…Therefore, they should be examined carefully in order to detect hereditary diseases and to apply preventive measures. Interestingly, Hadji and colleagues identified dental problems and less sport activity in childhood as risk factors for the development of PAO [7]. Especially, dental problems (e.g., tooth loss, recurrent inflammation) might indicate the presence of hereditary disorders in this cohort [18,34,35], which would be in line with our findings.…”

“…However, they would not have been detected by this panel analysis, since only coding exons were screened. Besides the impact of genetics, additionally, deteriorating factors include an insufficient enteral calcium resorption (e.g., vitamin D deficiency [28], inflammatory bowel diseases [29]), drug side effects (e.g., steroids [30], proton pump inhibitors [31]), or immobilization [7], which possibly overburden the bone microarchitecture. A similar phenomenon is the first manifestation of a mild maturity-onset diabetes of the young (MODY) type 2 as gestational diabetes [32].…”

“…After delivery, the BMD may increase again to the lower end of the reference range [2,6]. However, previous studies reported severe cases, characterized by multiple vertebral compression fractures, which show a persistent reduction in BMD [2,7]. It was hypothesized that a preexisting low bone mass could explain these severe manifestations [2,8].…”

“…Exogenous factors such as malnutrition (i.e., anorexia nervosa [9]) or druginduced side effects (i.e., corticosteroids [10], heparin [11]) have been discussed as the basis of low bone mass and quality in these cases. Furthermore, Hadji and colleagues identified severe dental problems, lack of exercise in childhood, and immobility to be associated with PAO [7]. As a matter of fact, there are also indications of genetic factors that may promote PAO.…”

Changes in bone mineral density and bone turnover markers during treatment with teriparatide in pregnancy‐ and lactation‐associated osteoporosis

“…Pregnancy‐ and lactation‐associated osteoporosis (PLO) is an uncommon disease characterized by the occurrence of fragility fractures, most commonly in the vertebral column, in the third trimester of pregnancy or early postpartum . The pathogenesis of PLO remains unclear owing to its rarity, which hampers the development of efficient treatment approaches .…”