Serum concentrations of intact parathyroid hormone during late human pregnancy: a longitudinal study

Frølich, Anne; Rudnicki, Martin; Fischer-Rasmussen, Wiggó; Olofsson, Kern

doi:10.1016/0028-2243(91)90166-i

Cited by 33 publications

(15 citation statements)

References 10 publications

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“…Our present results, together with the findings of others (16,23,26), have not confirmed the pregnancyassociated increases in PTH that have been reported previously. Intact-PTH concentrations tended to decrease during the course of pregnancy, but to increase postpartum, suggesting a state of 'secondary hyperparathyroidism' that may prevail to compensate for the transfer of calcium into the mammary glands for milk production (Fig.…”

Section: European Journal Of Endocrinology (1997) 137contrasting

confidence: 95%

“…The stimulus for the increase in calcitriol during pregnancy remains unknown, however. It seems to be unrelated to serum PTH, as the concentrations of intact-PTH were found to decrease with advancing gestation in our pregnant women, which is consistent with several earlier findings (16,(23)(24)(25)(26). In addition, an increase in intact-PTH concentrations postpartum paralleled a decrease in the concentrations of calcitriol (Figs 1 and 2), thus the increase in PTH postpartum did not result in further synthesis of calcitriol -an expected stimulus for enhanced calcium absorption.…”

Section: European Journal Of Endocrinology (1997) 137supporting

confidence: 91%

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Calcium-regulating hormones and parathyroid hormone-related peptide in normal human pregnancy and postpartum: a longitudinal study

Ardawi

Nasrat²,

Ba'Aqueel³

1997

European Journal of Endocrinology

174

133

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Objectives: To evaluate calcium-regulating hormones and parathyroid hormone-related peptide (PTHrP) in normal human pregnancy and postpartum in women not deficient in vitamin D. Design: A prospective longitudinal study was conducted in pregnant Saudi women during the course of pregnancy (n ¼ 40), at term and 6 weeks postpartum (n ¼ 18). Maternal concentrations of serum calcidiol and calcitriol were determined, together with those of serum intact-parathyroid hormone (PTH), PTHrP, calcitonin, osteocalcin, human placental lactogen (hPL), prolactin, vitamin D binding protein, alkaline phosphatase, calcium, phosphate and magnesium. A group of non-pregnant women (n ¼ 280) were included for comparative purposes. Results: The calcidiol concentrations decreased (meanϮS.D.) significantly from 54Ϯ10 nmol/l in the first trimester to 33Ϯ8 nmol/l in the third trimester (P < 0:001) and remained decreased at term and postpartum (both P < 0:001). The calcitriol concentration increased through pregnancy, from 69Ϯ17 pmol/l in the first trimester to 333Ϯ83 pmol/l at term (P < 0:001). Intact-PTH concentrations increased from 1.31Ϯ0.25 pmol/l in the first trimester to 2.26Ϯ0.39 pmol/l in the second trimester, but then declined to values of the first trimester and increased significantly postpartum (4.02Ϯ0.36 pmol/l) (P < 0:001). PTHrP concentration increased through pregnancy from 0.81Ϯ0.12 pmol/l in the first trimester to 2.01Ϯ0.22 pmol/l at term and continued its increase postpartum (2.63Ϯ0.15 pmol/l) (P < 0:001). Significant positive correlations were evident between PTHrP and alkaline phosphatase up to term (r ¼ 0:051, P < 0:001) and between PTHrP and calcitriol (r ¼ 0:46, P < 0:001), osteocalcin (r ¼ 0:23, P < 0:05) and prolactin (r ¼ 0:41, P < 0:05) during pregnancy. Osteocalcin started to increase from 0.13Ϯ0.01 nmol/l in the second trimester, through pregnancy and postpartum (P < 0:001). Calcitonin was increased more than twofold by the second trimester compared with the first trimester (P < 0:001) and subsequently decreased (P < 0:001). Prolactin concentrations were significantly greater in the second (6724Ϯ1459 pmol/l) and third (8394Ϯ2086 pmol/l) trimesters compared with values before pregnancy (P < 0:001). hPL increased throughout the course of pregnancy, reaching a maximum at term (7.61Ϯ2.57 mIU/ml). There was no direct correlation between serum calcitriol concentrations during pregnancy and serum prolactin (r ¼ ¹0:12, P < 0:19) or serum hPL (r ¼ 0:17, P < 0:21). Significant changes were observed in the serum concentrations of calcium and phosphate, but not in that of magnesium, during the course of pregnancy; calcium concentrations showed a maximal decrease at term. Conclusions: Changes in serum PTHrP during the course of pregnancy, at term and postpartum have been demonstrated, suggesting that the placenta (during pregnancy) and mammary glands (postpartum) are the main sources of PTHrP. No support for the concept of 'physiological hyperparathyroidism' of pregnancy could be demonstrated in the present work. The ...

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Section: European Journal Of Endocrinology (1997) 137contrasting

confidence: 95%

Section: European Journal Of Endocrinology (1997) 137supporting

confidence: 91%

Calcium-regulating hormones and parathyroid hormone-related peptide in normal human pregnancy and postpartum: a longitudinal study

Ardawi

Nasrat²,

Ba'Aqueel³

1997

European Journal of Endocrinology

174

133

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“…Serum phosphorus shows no change in most studies during human pregnancy (33,207,221,294,468,632,641,674,791) and was similarly unchanged during twin pregnancies (646). There is also no change in the renal tubular reabsorption of phosphorus (207,329,468).…”

Section: Calcium and Phosphorusmentioning

confidence: 93%

“…There is also no change in the renal tubular reabsorption of phosphorus (207,329,468). Serum magnesium is similarly unaltered during pregnancy (33,207,221,294,721).…”

Section: Calcium and Phosphorusmentioning

confidence: 99%

“…Later innovations resulted in the ability to measure the ionized calcium with ion-specific electrodes. Both cross-sectional (210,227,324) and longitudinal studies (221,294,721,739,791,809,813) have shown that the ionized calcium does not change during human pregnancy, even though the mean serum calcium simultaneously drops ϳ10% into the hypocalcemic range (221).…”

Section: Calcium and Phosphorusmentioning

confidence: 99%

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Maternal Mineral and Bone Metabolism During Pregnancy, Lactation, and Post-Weaning Recovery

Kovacs

2016

Physiological Reviews

338

524

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During pregnancy and lactation, female physiology adapts to meet the added nutritional demands of fetuses and neonates. An average full-term fetus contains ϳ30 g calcium, 20 g phosphorus, and 0.8 g magnesium. About 80% of mineral is accreted during the third trimester; calcium transfers at 300-350 mg/day during the final 6 wk. The neonate requires 200 mg calcium daily from milk during the first 6 mo, and 120 mg calcium from milk during the second 6 mo (additional calcium comes from solid foods). Calcium transfers can be more than double and triple these values, respectively, in women who nurse twins and triplets. About 25% of dietary calcium is normally absorbed in healthy adults. Average maternal calcium intakes in American and Canadian women are insufficient to meet the fetal and neonatal calcium requirements if normal efficiency of intestinal calcium absorption is relied upon. However, several adaptations are invoked to meet the fetal and neonatal demands for mineral without requiring increased intakes by the mother. During pregnancy the efficiency of intestinal calcium absorption doubles, whereas during lactation the maternal skeleton is resorbed to provide calcium for milk. This review addresses our current knowledge regarding maternal adaptations in mineral and skeletal homeostasis that occur during pregnancy, lactation, and post-weaning recovery. Also considered are the impacts that these adaptations have on biochemical and hormonal parameters of mineral homeostasis, the consequences for long-term skeletal health, and the presentation and management of disorders of mineral and bone metabolism.

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Pregnancy and lactation as risk factors for subsequent bone loss and osteoporosis

Sowers

1996

Journal of Bone and Mineral Research

210

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Serum concentrations of intact parathyroid hormone during late human pregnancy: a longitudinal study

Cited by 33 publications

References 10 publications

Calcium-regulating hormones and parathyroid hormone-related peptide in normal human pregnancy and postpartum: a longitudinal study

Calcium-regulating hormones and parathyroid hormone-related peptide in normal human pregnancy and postpartum: a longitudinal study

Maternal Mineral and Bone Metabolism During Pregnancy, Lactation, and Post-Weaning Recovery

Pregnancy and lactation as risk factors for subsequent bone loss and osteoporosis

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