Effect of bed rest during pregnancy on bone turnover markers in pregnant and postpartum women

Kaji, Tatsuru; Yasui, Toshiyuki; Suto, M.; Mitani, Ryuji; Momoeda, Mikio; Uemura, Hirokazu; Maeda, Keisuke; Irahara, Minoru

doi:10.1016/j.bone.2006.11.018

Cited by 36 publications

(19 citation statements)

References 19 publications

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“…We are yet to find similar evaluations directly in a pregnant cohort in the literature. A previous study on the effects of prolonged bed rest during pregnancy and its effects on bone metabolism showed a significant increase in bone turnover markers in these immobilized women, indicating a negative impact on BMD [20]. These findings apparently supported our hypothesis that exercises would help to attenuate the physiological loss in BMD.…”

Section: Discussionsupporting

confidence: 85%

Bone mineral density changes during pregnancy in actively exercising women as measured by quantitative ultrasound

Wong

2012

Arch Gynecol Obstet

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ObjectiveTo evaluate whether bone mineral density (BMD) changes in women engaged in active exercises during pregnancy would be different from non-exercising women.MethodsConsecutive patients with singleton pregnancies who were engaged in active exercise training during pregnancy were prospectively recruited over a period of 6 months. Quantitative USG measurements of the os calcis BMD were performed at 14–20 weeks and at 36–38 weeks. These patients were compared to a control cohort of non-exercising low-risk women.ResultsA total of 24 physically active women undergoing active physical training of over 10 h per week at 20 weeks gestation and beyond (mean 13.1 h, SD 3.3) were compared to 94 non-exercising low-risk women. A marginal fall in BMD of 0.015 g/cm2 (SD 0.034) was demonstrable from early to late gestation in the exercising women, which was significantly lower than that of non-exercising women (0.041 g/cm2; SD 0.042; p = 0.005). Logistic regression models confirmed that active exercises in pregnancy were significantly associated with the absence of or less BMD loss in pregnancy.ConclusionIn women actively engaged in physical training during pregnancy, the physiological fall in BMD during pregnancy was apparently less compared to those who did not regularly exercise.

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Section: Discussionsupporting

confidence: 85%

Bone mineral density changes during pregnancy in actively exercising women as measured by quantitative ultrasound

Wong

2012

Arch Gynecol Obstet

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“…The higher serum levels of bone alkaline phosphatase are measured and increases in type 1 collagen are indicative of increased bone turnover in women on bed rest. The level of serum bone alkaline phosphatase was also significantly correlated with the duration of bed rest ( r = 0.767, P = 0.0041) 7. Because of the loss of postural cues, circadian rhythm disturbances lead to altered sleep/wake cycles, fatigue, and insomnia.…”

Section: Potential Complicationsmentioning

confidence: 91%

“…Maloni4 summarizes NASA's research, which found that the supine position (a surrogate for bed rest) leads to several physiologic adaptive changes, including changes in hydrostatic gradients and alterations in the cardiovascular/cardiopulmonary, fluid and electrolyte, hormonal, hematologic, musculoskeletal and neurosensory/vestibular systems. These physiologic alterations ultimately lead to debilitative symptoms during bed rest and recovery, including muscle atrophy5 and bone demineralization 6,7. Maloni also highlights an organizational framework based on the aerospace research to explain some of the adverse effects of bed rest and guide future directions for research on antepartum bed rest 4.…”

mentioning

confidence: 99%

Bed Rest in Pregnancy

Bigelow

Stone

2011

Mount Sinai J Medicine

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The use of bed rest in medicine dates back to Hippocrates, who first recommended bed rest as a restorative measure for pain. With the formalization of prenatal care in the early 1900s, maternal bed rest became a standard of care, especially toward the end of pregnancy. Antepartum bed rest is a common obstetric management tool, with up to 95% of obstetricians utilizing maternal activity restriction in some way in their practice. Bed rest is prescribed for a variety of complications of pregnancy, from threatened abortion and multiple gestations to preeclampsia and preterm labor. Although the use of bed rest is pervasive, there is a paucity of data to support its use. Additionally, many well-documented adverse physical, psychological, familial, societal, and financial effects have been discussed in the literature. There have been no complications of pregnancy for which the literature consistently demonstrates a benefit to antepartum bed rest. Given the well-documented adverse effects of bed rest, disruption of social relationships, and financial implications of this intervention, there is a real need for scientific investigation to establish whether this is an appropriate therapeutic modality. Well-designed randomized, controlled trials of bed rest versus normal activity for various complications of pregnancy are required to lay this debate to rest once and for all.

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“…Women with initially elevated blood lead levels must be closely monitored for rising levels following the schedule in Table 2 and should be reassessed at each visit for relevant complications such as anemia or hypertension. A woman with an initially normal blood lead level and known risk factors for past exposure should be rechecked as pregnancy progresses, especially if she is prescribed bed rest, as this has been shown to increase bone mobilization 31 . Blood lead levels also should be rechecked in these women if potentially lead‐related complications develop to ensure that appropriate interventions are carried out.…”

Section: Clinical Management Of Elevated Lead Levels In Pregnancy Andmentioning

confidence: 99%

Increased Lead Levels in Pregnancy Among Immigrant Women

Alba¹,

Carleton²,

Dinkel³

et al. 2012

J Midwife Womens Health

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Antepartum lead screening typically involves identification of current environmental or occupational risk and pica habits. However, for foreign-born women who have immigrated to the United States, distant exposure years prior may be a more significant factor contributing to elevated lead levels. Because lead can be stored in bone for decades and mobilized to the blood when calcium needs increase in pregnancy, women and their children can be at risk for lead-related complications like anemia, gestational hypertension, preterm labor, low birth weight, and developmental delays without any identifiable current exposure. Midwives and other women's health clinicians must carefully evaluate the history of every woman under their care, individualizing screening and treatment to identify risk and provide timely intervention.

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Effect of bed rest during pregnancy on bone turnover markers in pregnant and postpartum women

Cited by 36 publications

References 19 publications

Bone mineral density changes during pregnancy in actively exercising women as measured by quantitative ultrasound

Bone mineral density changes during pregnancy in actively exercising women as measured by quantitative ultrasound

Bed Rest in Pregnancy

Increased Lead Levels in Pregnancy Among Immigrant Women

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