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Fractures within 2 years of an obstetric hospitalization: analysis of nationwide administrative data in Japan

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Journal of Bone and Mineral Metabolism Aims and scope Submit manuscript

Abstract

Introduction

Pregnancy- and lactation-associated osteoporosis (PLO) is a condition in which young women develop fractures during pregnancy or breastfeeding. Though PLO is a severely debilitating disease, its pathophysiology and epidemiology have not been clarified and its treatment has not been established. We aimed to identify the incidence and factors associated with fractures occurring within 2 years following an obstetric hospitalization.

Materials and methods

We extracted data on fractures occurring within 2 years of an obstetric hospitalization from the Japanese Diagnosis Procedure Combination database. We analyzed the implementation of bone mineral density and bone metabolism marker tests, prescription status, and factors associated with fractures occurring within 2 years of an obstetric hospitalization.

Results

Among 837,347 patients with a history of obstetric hospitalization from 2010 to 2014, 379 patients had a history of hospitalization due to a fracture occurring within 2 years (4.5/10,000 pregnancies). Among the patients with fractures occurring within 2 years of an obstetric hospitalization, 6.7% underwent bone mineral quantification or a bone metabolism marker test, and 7.5% were prescribed a lactation inhibitor or osteoporosis treatment. Factors associated with fractures occurring within 2 years following an obstetric hospitalization identified included Cushing syndrome, Charlson Comorbidity Index score ≥ 1, age ≥ 40 years old at pregnancy, smoking history, and steroid administration.

Conclusion

We investigated fracture cases occurring within 2 years of an obstetrics hospitalization. This finding may be useful in selecting preventative measures for patients at risk of fractures within 2 years after obstetric hospitalization, including PLO.

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Acknowledgements

We thank Shyunji Shimoda for his assistance with data analysis.

Funding

This study was undertaken with the support of the Japan Osteoporosis Foundation research grant 2671.

Author information

Authors and Affiliations

  1. Quality Management Center, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo, Tokyo, 113-8510, Japan

    Mikayo Toba, Mutsuko Moriwaki & Kiyohide Fushimi

  2. Department of Women’s Health, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo, Tokyo, 113-8510, Japan

    Masakazu Terauchi

  3. Department of Obstetrics and Gynecology, Dokkyo Medical University School of Medicine, 880, Kitakobayashi, Mibu, Tochigi, 321-0293, Japan

    Satoshi Obayashi

  4. Department of Comprehensive Reproductive Medicine, Graduate School of Medicine, Tokyo Medical and Dental University, Yushima1-5-45, Bunkyo, Tokyo, 113-8510, Japan

    Naoyuki Miyasaka

  5. Department of Health Policy and Informatics, Tokyo Medical and Dental University, Yushima1-5-45, Bunkyo, Tokyo, 113-8510, Japan

    Kiyohide Fushimi

Authors
  1. Mikayo Toba
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  2. Masakazu Terauchi
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  3. Mutsuko Moriwaki
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  4. Satoshi Obayashi
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  5. Naoyuki Miyasaka
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  6. Kiyohide Fushimi
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Contributions

Conceptualization: MT, MT; formal analysis: MT, MM; methodology: MM, KF; resources: KF; visualization: SO; writing—original draft: MT; writing—review and editing: MT, SO, NM, KF.

Corresponding author

Correspondence to Kiyohide Fushimi.

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Conflict of interest

Kiyohide Fushimi, Mikayo Toba, Masakazu Terauchi, Mutsuko Moriwaki, Satoshi Obayashi, and Naoyuki Miyasaka declare that they have no conflict of interest.

Ethics approval

This study was conducted with the approval of the ethics committee of Tokyo Medical and Dental University (approval number M2000-2202).

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Written informed consent was not required because of the anonymous nature of the data.

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The participants agreed for data to be published.

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Toba, M., Terauchi, M., Moriwaki, M. et al. Fractures within 2 years of an obstetric hospitalization: analysis of nationwide administrative data in Japan. J Bone Miner Metab 40, 748–754 (2022). https://doi.org/10.1007/s00774-022-01336-4

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  • DOI: https://doi.org/10.1007/s00774-022-01336-4

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