Risk factors, fractures, and management of pregnancy-associated osteoporosis: a retrospective study of 14 Turkish patients

Gynecol Endocrinol. 2020 Mar;36(3):238-242. doi: 10.1080/09513590.2019.1648417. Epub 2019 Aug 6.

Abstract

Pregnancy-associated osteoporosis (PAO) is a rare but painful disease. The current study aimed to investigate the demographic and clinical features, risk factors, treatment options, and outcomes of Turkish patients with PAO. In our retrospective, cross-sectional, and descriptive study the time to PAO diagnosis was 3.6 months. Pain and loss of height were detected in 78.6% and 28.6% of patients, respectively. As such, 60.6% of patients reported fractures at the thoracic area, 30.3% at the lumbar area, and 9.1% at the sacral area. While 14.3% of patients had optimal vitamin D status during pregnancy, 64.3% had vitamin D deficiency, and 21.4% had vitamin D insufficiency. Of the patients, 21.4% received anticoagulant therapy during their pregnancy. Dual X-ray absorptiometry scans revealed that osteoporosis was predominantly in the trabecular bone (L1-L4 Z-score -2.9, Femur Z score -2.19). Management options included supplements of calcium with vitamin D (93%), weaning the baby (79%), specific treatments for osteoporosis (64%), use of a supportive corset (50%), and exercise (21%), respectively. In addition, after delivery, 35.7% of patients were administered denosumab, 21.4% bisphosphonate, and 7.1% were given teriparatide. Data of the clinical features, treatments, and outcomes of PAO may contribute to early detection and management.

Keywords: Osteoporosis; pain; pregnancy; risk factors; vertebral fractures.

MeSH terms

  • Absorptiometry, Photon
  • Adult
  • Bone Density Conservation Agents / therapeutic use*
  • Calcium / therapeutic use
  • Cross-Sectional Studies
  • Denosumab / therapeutic use
  • Diphosphonates / therapeutic use
  • Female
  • Humans
  • Immobilization
  • Lumbar Vertebrae / injuries
  • Osteoporosis / epidemiology*
  • Osteoporosis / therapy
  • Osteoporotic Fractures / epidemiology*
  • Pain
  • Pregnancy
  • Pregnancy Complications / epidemiology*
  • Resistance Training
  • Retrospective Studies
  • Risk Factors
  • Sacrum / injuries
  • Smoking / epidemiology
  • Spinal Fractures / epidemiology*
  • Teriparatide / therapeutic use
  • Thoracic Vertebrae / injuries
  • Turkey / epidemiology
  • Vitamin D / analogs & derivatives
  • Vitamin D / blood
  • Vitamin D / therapeutic use
  • Vitamin D Deficiency / blood
  • Vitamin D Deficiency / drug therapy
  • Vitamin D Deficiency / epidemiology*

Substances

  • Bone Density Conservation Agents
  • Diphosphonates
  • Teriparatide
  • Vitamin D
  • Denosumab
  • 25-hydroxyvitamin D
  • Calcium