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Review
. 2022 Feb 19;17(1):36.
doi: 10.1007/s11657-022-01077-x.

Bone metabolism and osteoporosis during pregnancy and lactation

Affiliations
Review

Bone metabolism and osteoporosis during pregnancy and lactation

Abraham Yair Lujano-Negrete et al. Arch Osteoporos. .

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.

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References

    1. Sanz-Salvador L, García-Pérez M, Tarín JJ, Cano A (2015) Bone metabolic changes during pregnancy: a period of vulnerability to osteoporosis and fracture. Eur J Endocrinol 172:R53-65 - PubMed - DOI
    1. Camacho PM, Petak SM, Binkley N et al (2020) American Association of Clinical Endocrinologists/American College of Endocrinology Clinical Practice guidelines for the diagnosis and treatment of postmenopausal osteoporosis-2020 UPDATE. Endocr Pract 26:1–46 - PubMed - DOI
    1. Leere JS, Vestergaard P (2019) Calcium metabolic disorders in pregnancy: primary hyperparathyroidism, pregnancy-induced osteoporosis, and vitamin D deficiency in pregnancy. Endocrinol Metab Clin North Am 48:643–655 - PubMed - DOI
    1. Phillips AJ, Ostlere SJ, Smith R (2000) Pregnancy-associated osteoporosis: does the skeleton recover? Osteoporos Int 11:449–454 - PubMed - DOI
    1. Barbour LA, Kick SD, Steiner JF, LoVerde ME, Heddleston LN, Lear JL, Barón AE, Barton PL (1994) A prospective study of heparin-induced osteoporosis in pregnancy using bone densitometry. Am J Obstet Gynecol 170:862–869 - PubMed - DOI

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