
Osteoporosis can occur during pregnancy (gestational osteoporosis). Illustration: Anatomy & Physiology, Connexions Web site / Wikimedia. CC BY 3.0
Pregnancy and osteoporosis
Contents
Definition
Osteoporosis (osteoporosis) related to pregnancy and lactation is a rare but well-known condition. Most often, healthy women are affected during the last part of pregnancy or during the period when they are breastfeeding.
Disease Cause
- During pregnancy, the structure of the fetus skeletal requires that large amounts of calcium (lime) are transferred from the pregnant skeleton
- Milk production during breastfeeding drains the woman of calcium in addition to estrogen being low. It is estimated that women have 4-6% loss of bone mass during the first 6 months of breastfeeding (reference: Hopkinson JM, 2000)
- It is still unclear why some women develop severe osteoporosis related to pregnancy, but some are predisposed:
- Genetic (hereditary) disposition
- Lack of lime and Vitamin D
- Use of heparin (blood thinning)
- Low body weight
- Unrecognized disease
Symptom
Suddenly, strong and persistent pain located to the spine in the last part of pregnancy or lactation
- The pain becomes worse by almost all kind of motion
- Vertebrae in the vertebral column and the lower back are most often attacked
- Pain in the chest can be caused by rib fractures
Medical examinations and diagnosis
- Larger fractures appear on radiographs
- MRI investigations of the spine is most accurate
- For bone density measurement (Dexa Scan) low bone density due to calcium deficiency can be detected
- However, some have good bone density, but damaged structure (trabecler) in the bone tissue and subsequent fractures.
Treatment
- Calcium and vitamin D can be used throughout the pregnancy and during breastfeeding
- Alendronate tablets are often used for osteoporosis, but should not be used during pregnancy and lactation
- Teriparatide (Forsteo) may contribute to the development of the skeleton, but should not be used during pregnancy or lactation
Prognosis
New pregnancies occur in about one in three.