Bone metabolism and osteoporosis during pregnancy and lactation
- PMID: 35182221
- DOI: 10.1007/s11657-022-01077-x
Bone metabolism and osteoporosis during pregnancy and lactation
Abstract
Purpose: Osteoporosis in pregnancy is an uncommon disease and there is little information regarding its pathogenesis and its effects on the skeleton. This review aims to describe changes in mineral metabolism during pregnancy and lactation as well as their clinical impact.
Methods: We performed a narrative review of the literature using the PubMed and Google Scholar databases for articles published from 1955 to 2021.
Results: Mineral metabolism in the mother must adapt to the demand created by the fetus and the placenta, which together absorb calcium and other minerals from the mother to mineralize the developing fetal skeleton; analyses of iliac bone biopsies at the beginning and end of pregnancy have shown that pregnancy significantly modifies maternal bone status. The greatest demand for calcium for the maternal skeleton occurs during lactation; women who breastfeed have an even greater loss of calcium to produce milk. However, it is controversial whether breastfeeding can increase the risk of osteoporotic fractures, and the possible mechanism is considerably complicated. Osteoporosis in pregnancy is an uncommon disease characterized by the occurrence of fragility fractures, most commonly in the vertebral column, in the third trimester of pregnancy, or early postpartum. The pathogenesis of PLO remains unclear owing to its rarity; DXA provides a sensitive and specific method for diagnosing osteoporosis by measuring BMD, one of the parameters that allow a better understanding of fracture risk. One limitation is the controversy in using radiation in pregnant women and the risk to the embryo/fetus; a safe alternative can be MRI.
Conclusion: Pregnancy and lactation alter the maternal bone status; without a balance in metabolism, this may cause an increased risk of fracture due to changes in BMD. There is little information on BMD during pregnancy; more clinical studies are required to elucidate if this represents a risk factor for osteoporosis.
Keywords: DXA; Lactation; Osteoporosis; Pregnancy.
© 2022. International Osteoporosis Foundation and National Osteoporosis Foundation.
Similar articles
-
Intertrochanteric fracture in pregnancy- and lactation-associated osteoporosis.J Int Med Res. 2020 Feb;48(2):300060519858013. doi: 10.1177/0300060519858013. Epub 2019 Jul 1. J Int Med Res. 2020. PMID: 31256731 Free PMC article.
-
Presentation and management of osteoporosis presenting in association with pregnancy or lactation.Osteoporos Int. 2015 Sep;26(9):2223-41. doi: 10.1007/s00198-015-3149-3. Epub 2015 May 5. Osteoporos Int. 2015. PMID: 25939309 Review.
-
Women With Pregnancy and Lactation-Associated Osteoporosis (PLO) Have Low Bone Remodeling Rates at the Tissue Level.J Bone Miner Res. 2019 Sep;34(9):1552-1561. doi: 10.1002/jbmr.3750. Epub 2019 Jul 26. J Bone Miner Res. 2019. PMID: 31348548 Free PMC article.
-
Utilization of DXA Bone Mineral Densitometry in Ontario: An Evidence-Based Analysis.Ont Health Technol Assess Ser. 2006;6(20):1-180. Epub 2006 Nov 1. Ont Health Technol Assess Ser. 2006. PMID: 23074491 Free PMC article.
-
Bone mineral changes during pregnancy and lactation.Endocrine. 2002 Feb;17(1):49-53. doi: 10.1385/ENDO:17:1:49. Endocrine. 2002. PMID: 12014704 Review.
Cited by
-
Association between risk factors and bone mineral density and the development of a self-assessment tool for early osteoporosis screening in postmenopausal women with type 2 diabetes.PeerJ. 2024 Oct 11;12:e18283. doi: 10.7717/peerj.18283. eCollection 2024. PeerJ. 2024. PMID: 39403190 Free PMC article.
-
Association between Dietary Inflammatory Index and Bone Mineral Density Changes among Pregnant Women: A Prospective Study in China.Nutrients. 2024 Feb 5;16(3):455. doi: 10.3390/nu16030455. Nutrients. 2024. PMID: 38337739 Free PMC article.
-
Longitudinal changes of the femoral bone mineral density from first to third trimester of pregnancy: bone health assessment by means of non-ionizing REMS technology.Aging Clin Exp Res. 2024 Feb 9;36(1):31. doi: 10.1007/s40520-023-02677-4. Aging Clin Exp Res. 2024. PMID: 38334854 Free PMC article.
-
Recent Insights into Pregnancy and Lactation-Associated Osteoporosis (PLO).Int J Womens Health. 2023 Aug 2;15:1227-1238. doi: 10.2147/IJWH.S366254. eCollection 2023. Int J Womens Health. 2023. PMID: 37551335 Free PMC article. Review.
-
Bridging the Gap: Pregnancy-And Lactation-Associated Osteoporosis.Diagnostics (Basel). 2023 May 3;13(9):1615. doi: 10.3390/diagnostics13091615. Diagnostics (Basel). 2023. PMID: 37175006 Free PMC article. Review.
References
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical
