Pregnancy-associated osteoporosis: a UK case series and literature review

Hardcastle, Sarah; Yahya, Fariz; Bhalla, A. K.

doi:10.1007/s00198-019-04842-w

Cited by 33 publications

(26 citation statements)

References 22 publications

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“…During pregnancy and lactation, the changes in calcium metabolism lead to a transient bone loss, mainly at trabecular sites (91). Among the factors involved, parathyroid hormone related protein is secreted into the maternal circulation from the breasts tissue and placenta and reaches its highest concentrations during the third trimester.…”

Section: Pregnancy-and Lactation-associated Osteoporosismentioning

confidence: 99%

Osteoporosis in Premenopausal Women: A Clinical Narrative Review by the ECTS and the IOF

Pepe

Body

Hadji

et al. 2020

The Journal of Clinical Endocrinology &Amp; Metabolism

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Abstract Context Consensus regarding diagnosis and management of osteoporosis in premenopausal women (PW) is still lacking due to few studies carried out in this population. Design The European Calcified Tissue Society and the International Osteoporosis Foundation convened a working group to produce an updated review of literature published after 2017 on this topic. Results Fragility fractures in PW are rare and mostly due to secondary osteoporosis (ie, in presence of an underlying disease such as hormonal, inflammatory, or digestive disorders). In absence of another disorder, low bone mineral density (BMD) together with fragility fractures qualifies as idiopathic osteoporosis. In contrast, low BMD alone does not necessarily represent osteoporosis in absence of bone microarchitectural abnormalities. BMD increases in PW with osteoporosis when the underlying disease is treated. For example, in celiac disease, an increase of 9% in radius trabecular volumetric density was achieved after 1 year of gluten-free diet, while anti-tumor necrosis factor alpha improved BMD in PW with inflammatory bowel diseases. In amenorrhea, including anorexia nervosa, appropriately delivered estrogen replacement therapy can also improve BMD. Alternatively, antiresorptive or anabolic therapy has been shown to improve BMD in a variety of conditions, the range of improvement (3%-16%) depending on skeletal site and the nature of the secondary cause. No studies were powered to demonstrate fracture reduction. The effects of bisphosphonates in childbearing women have been scantly studied and caution is needed. Conclusion The majority of PW with osteoporosis have an underlying disease. Specific therapy of these diseases, as well as antiresorptive and anabolic drugs, improve BMD, but without evidence of fracture reduction.

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Section: Pregnancy-and Lactation-associated Osteoporosismentioning

confidence: 99%

Osteoporosis in Premenopausal Women: A Clinical Narrative Review by the ECTS and the IOF

Pepe

Body

Hadji

et al. 2020

The Journal of Clinical Endocrinology &Amp; Metabolism

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“…Some recent articles reported bilateral femoral neck fractures occurring secondary to transient osteoporosis of the hip in postpartum patients [5, 6]. Although pregnancy-associated osteoporosis occurring during late pregnancy and in the early postpartum period has been reported [20], our case is different from these cases because it involves a young man.…”

Section: Discussionmentioning

confidence: 62%

Spontaneous bilateral femoral neck fractures in a young male adult: a case report and literature review

Arisumi

Mawatari

Ikemura

et al. 2019

BMC Musculoskelet Disord

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Background Simultaneous bilateral femoral neck fracture is a very rare condition, even in osteoporotic elderly individuals. We report an atypical case of a young male adult who developed simultaneous bilateral femoral neck fractures without previous trauma or overuse. Case presentation A 33-year-old man presented with discomfort in the bilateral groin, which had started 2 weeks previously. Bilateral femoral neck fractures were observed on a radiograph, and in addition, a fracture line was seen at the right subchondral region of the acetabulum using magnetic resonance imaging (MRI). Although the patient had no obvious risk factors associated with bone fragility, his bone mineral density measured using dual X-ray absorptiometry indicated severe osteoporosis (lumber spine: T score − 3.4 standard deviation [SD]; femoral neck: T score − 2.8 SD). Serum 25-hydroxyvitamin D level was deficient (19 ng/mL), which was considered to be partly due to non-sunlight exposure for 3 years owing to social withdrawal. Bilateral osteosynthesis was performed, considering his young age, although more than 2 weeks had passed since the onset of the fracture. Bone union and non-occurrence of osteonecrosis of the femoral head were confirmed via radiography and MRI 8 months after the surgery. Conclusions Our case suggests that simultaneous non-traumatic bilateral femoral neck fractures can occur in healthy young men.

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“…In rare cases, fragility fractures may ensue during pregnancy or lactation, accompanied by a persistently low bone mineral density; this entity is referred to as “pregnancy- and lactation-associated osteoporosis”. A number of recent excellent overviews have been published on this subject [ 15 , 16 , 17 ], which is outside the scope of this current review.…”

Section: Calcium Physiology During Pregnancy and Lactationmentioning

confidence: 99%

Parathyroid Disease in Pregnancy and Lactation: A Narrative Review of the Literature

Tsourdi

Anastasilakis

2021

Biomedicines

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Pregnancy and lactation are characterized by sophisticated adaptations of calcium homeostasis, aiming to meet fetal, neonatal, and maternal calcium requirements. Pregnancy is primarily characterized by an enhancement of intestinal calcium absorption, whereas during lactation additional calcium is obtained through resorption from the maternal skeleton, a process which leads to bone loss but is reversible following weaning. These maternal adaptations during pregnancy and lactation may influence or confound the presentation, diagnosis, and management of parathyroid disorders such as primary hyperparathyroidism or hypoparathyroidism. Parathyroid diseases are uncommon in these settings but can be severe when they occur and may affect both maternal and fetal health. This review aims to delineate the changes in calcium physiology that occur with pregnancy and lactation, describe the disorders of calcium and parathyroid physiology that can occur, and outline treatment strategies for these diseases in the above settings.

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Pregnancy-associated osteoporosis: a UK case series and literature review

Cited by 33 publications

References 22 publications

Osteoporosis in Premenopausal Women: A Clinical Narrative Review by the ECTS and the IOF

Osteoporosis in Premenopausal Women: A Clinical Narrative Review by the ECTS and the IOF

Spontaneous bilateral femoral neck fractures in a young male adult: a case report and literature review

Parathyroid Disease in Pregnancy and Lactation: A Narrative Review of the Literature

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