Osteoporosis presenting in pregnancy, puerperium, and lactation

Abstract

These relatively rare fragility fractures result from multifactorial causes, including skeletal disorders that precede pregnancy, and structural and metabolic stresses that can compromise skeletal strength during pregnancy and lactation. Further study is needed to determine when pharmacological or surgical therapy is warranted instead of conservative or expectant management.

Incorporation of Flaxseed Flour as a Dietary Source for ALA Increases Bone Density and Strength in Post‐Partum Female Rats

“…In women, bone mass undergoes changes during pregnancy, with bone physiology changes to compensate for the increased mineral needs, the developing fetus, and to supply calcium for milk production [1]. Subsequently, the lactation period is characterized by predominance of resorption and loss of bone content, particularly in the areas of trabecular bone, which is currently considered a significant predictor of osteoporotic fractures later in life [2,3]. It was reported that breastfeeding women lose about 5-7% of their bone mass over 6 months [4], and at the end of this period, longitudinal studies have shown a rapid reversal in bone metabolism, 6-24 months after weaning.…”

Clinical Case: Pregnancy lactation osteoporosis

“…It can recur in subsequent pregnancies, but because it is not a systemic disorder of bone metabolism, there is no clear rationale for pharmacological treatment with antiresorptives or teriparatide. 7 Daily teriparatide should be considered for young patients with pregnancy-and lactation-associated osteoporosis, especially those with multiple vertebral fractures, to avoid long-term morbidity. 8 Teriparatide is more effective than BPs with respect to BMD increase.…”

Ryggfrakturer og svangerskaps- og laktasjonsassosiert osteoporose

“…Under graviditeten hadde hun brukt kosttilskudd for gravide som inneholdt bl.a. kalsium og vitamin D. Hun ble anbefalt å avslutte ammingen for å unngå ytterligere bentap (1,2). Blodprøver viste normal senkningsreaksjon og normale verdier av C-reaktivt protein, kreatinin, vitamin D, kalsium, parathyreoideahormon, fosfat, magnesium, natrium, kalium, thyreoideastimulerende hormon, tyroksin, alkalisk fosfatase, alaninaminotransferase, s-transglutaminase-antistoff og s-elektroforese.…”

“…Svangerskap og amming medfører et forbigående bentap fordi kalsium overføres fra mor til barn for oppbygging av skjelettet (1,3). Svangerskaps-og laktasjonsassosiert osteoporose karakteriseres av høy benomsetning, som først kommer til uttrykk i tap av trabekulaert benvev der benoverflaten per volumenhet er størst (3).…”