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

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.

摘要

妊娠相关的骨质疏松症（PAO）是一种罕见并且痛苦的疾病。本研究旨在调查土耳其PAO患者的人口学和临床特征、危险因素、治疗方案和预后。在我们进行回顾性、横断面和描述性研究中, 诊断PAO的时间为3.6个月。78.6%的患者出现疼痛, 28.6%的患者出现身高下降。因此, 60.6%的患者报告有胸部骨折, 30.3%的患者报告出现腰椎骨折, 9.1%的患者出现骶骨骨折。14.3%的患者在妊娠期间维生素D处于理想状态, 64.3%的患者维生素D缺乏, 21.4%的患者维生素D不足。其中21.4%的患者在妊娠期间接受了抗凝治疗。双X线骨密度仪扫描显示骨质疏松主要发生在小梁骨(L1–L4 Z score–2.9, 股骨 Z score–2.19)。患者管理包括补充钙和维生素D（93%）, 婴儿断奶（79%）, 骨质疏松症的特殊治疗（64%）、使用支撑性束身衣（50%）和锻炼（21%）。此外, 在分娩后35.7%的患者应用地诺单抗, 21.4%的患者应用双膦酸盐, 7.1%的患者应用特立帕肽。临床特征、治疗和预后的资料可能有助于早期的发现及治疗。

The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Keywords:

• Osteoporosis
• pain
• pregnancy
• risk factors
• vertebral fractures

Disclosure statement

No potential conflict of interest was reported by the authors.

Author contributions

FT, CA, HÖ, and DDK conceived the study. FT, CA, and HÖ collected and analyzed data. FT, CA, HÖ, and DDK contributed to analyzing data, interpreting the results, and writing the paper.