, Volume 21, Issue 4, pp 709-710
Date: 16 Jun 2009

Maternal and fetal outcome after long-term bisphosphonate exposure before conception

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Dear Editors,

Despite a substantial increase in the use of bisphosphonates at childbearing age, very little is known regarding their risk during pregnancy. Bisphosphonate and particularly pamidronate therapy administered to girls and young women might adversely affect the outcome of subsequent pregnancies given the fact that bisphosphonates have been shown to cross the placenta in both animals and humans [1, 2] and persist in mineralized bone for many years [3]. In some published cases, bisphosphonate administration during human pregnancy was used to treat malignant hypercalcemia or pregnancy-associated osteoporosis without any adverse effects on the neonate [4, 5]. In 24 pregnancies following pre-pregnancy or early pregnancy alendronate treatment, it seems that alendronate does not have a major teratogenic risk [6]. There have previously been only two reports concerning pamidronate safety profile in women of childbearing age [7, 8]. In the first report, two women with osteogenesis impe