Changes in bone mass as determined by ultrasound and biochemical markers of bone turnover during pregnancy and puerperium: a longitudinal study.

Abstract

In a longitudinal study, we analyzed the speed of sound (SOS) and broadband ultrasound attenuation (BUA) of the os calcis as an index of bone mineral density (BMD) to define the effects of pregnancy and lactation on bone metabolism. We used an ultrasound bone densitometer and measured 6 biochemical markers of bone turnover in 18 healthy women throughout pregnancy and puerperium. The measurement of SOS and BUA by such an ultrasound device was clinically advantageous; not only is it radiation-free technology, but it also correlates highly with BMD measured by conventional X-ray bone densitometry. While a significant decrease in SOS was found in the 3rd trimester of pregnancy as compared with the early stage of pregnancy, there was no difference in both SOS and BUA between the breast-feeding women and the principally formula-feeding women during a 6-month period of puerperium. The analysis of biochemical markers revealed that both bone formation and bone resorption were elevated in the 3rd trimester of pregnancy as well as during puerperium, and that the breast-feeding women had significantly higher bone metabolism than the principally formula-feeding women. These results indicate that bone mass decreases as bone turnover itself is enhanced during pregnancy, while lactation does not substantially affect bone mass during at least 6 months of puerperium, although bone turnover is active.

Bone Physiology During Pregnancy and Lactation in Young Macaques

“…The measurements reflecting bone formation (osteoid surface, mineralizing surface, MAR) were markedly higher than at midpregnancy, with no change in the number of osteoclasts. The osteocalcin levels also showed dramatic increases, consistent with enhanced bone formation and similar to results from several other studies (14–15,22,32,35) . In normal bone, high resorption rates lead to high formation rates.…”

Calcium and phosphorus metabolism in peripartal dogs

“…This increased bone resorption during early lactation was also found in cats (Liesegang & Wichert, ) and could not be prevented by a realised intake of both minerals in excess to the recommended daily allowances given by NRC () and a positive mineral balance in eight of the nine bitches. This was also shown in other species (cow: Beighle, , Holtenius & Ekelund, , Horst et al, , Rowland et al, ; man: Sowers et al, , Yamaga et al, ). It can be hypothesised that further increase of dietary mineral supply in peripartal dogs will not prevent excessively increased bone turnover but might cause adverse effects such as reduced availability of other minerals.…”

Expression of Concern: Bone turnover in preeclampsia‐complicated pregnancy in North Indian women

“…It undergoes a continuous process of remodeling throughout life, which involves a delicate balance between bone resorption due to osteoclast activation and new bone formation due to osteoblastic activity 1 . Some studies have reported that bone turnover increases during normal pregnancy, resulting in a reduction in bone density, 2–4 whereas others have reported an increase 5 or no change 6 in bone density during normal pregnancy.…”

“…During pregnancy, changes in bone metabolism occur to meet the increased calcium demand of the fetus. Bone resorption is enhanced during the third trimester of gestation and the puerperium 4 . While various studies on the increase in bone turnover using biochemical markers during normal pregnancy have been reported, there are little data published for the same conducted on preeclamptic patients.…”