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Erschienen in: Osteoporosis International 7/2006

01.07.2006 | Original Article

Bisphosphonates in pregnancy and lactation-associated osteoporosis

verfasst von: S. M. O’Sullivan, A. B. Grey, R. Singh, I. R. Reid

Erschienen in: Osteoporosis International | Ausgabe 7/2006

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Abstract

Introduction

Pregnancy and lactation-associated osteoporosis (PLO) is an uncommon condition characterized by the occurrence of fracture(s) during late pregnancy or the puerperium. The aetiology is uncertain, and its management and natural history poorly defined.

Methods

We report a series of 11 women with PLO seen at our institution over the past 20 years, with follow-up ranging from 1 to 19 years.

Results

Ten women presented with painful low-trauma vertebral fractures, at a median of 1 month postpartum. In nine cases the fractures were multiple (median: 3, range: 2–5). At least one recognised risk factor for osteoporosis (low body weight, smoking history, family history of osteoporosis/fracture, vitamin D insufficiency) was present in nine patients. Bone density was in the osteoporotic range at the spine (mean T score: −2.8), with less marked reduction at the proximal femur (mean T score: −1.9). Nine patients received bisphosphonate treatment, for a median duration of 24 months. In the five women who received a bisphosphonate within 1 year of presentation, spinal bone density increased by 23% over baseline values after 2 years of treatment (p=0.0014). Of the 5 women who had subsequent pregnancies, one, who had declined bisphosphonate therapy after the initial presentation, sustained a fracture in the postpartum period. Two patients (both of whom were followed for at least 10 years) sustained fractures outside of pregnancy.

Conclusions

PLO is therefore associated with significant morbidity, a high prevalence of recognized risk factors for osteoporosis and a risk of recurrence in subsequent pregnancies. Bisphosphonate therapy administered soon after presentation substantially increases spinal bone density in patients with PLO.
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Metadaten
Titel
Bisphosphonates in pregnancy and lactation-associated osteoporosis
verfasst von
S. M. O’Sullivan
A. B. Grey
R. Singh
I. R. Reid
Publikationsdatum
01.07.2006
Verlag
Springer-Verlag
Erschienen in
Osteoporosis International / Ausgabe 7/2006
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-006-0112-3

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