Bone mineral density changes in pregnancies with gestational hypertension: a longitudinal study using quantitative ultrasound measurements
To compare the maternal bone mineral density (BMD) changes in gestational hypertensive and normotensive pregnancies using quantitative ultrasound.
Consecutive patients were recruited from a general obstetric clinic over a period of 9 months. BMD measurements were performed at the os calcis in early pregnancy before 20 weeks and in the late third trimester after 36 weeks, using a Hologic Sahara Clinical Bone Sonometer system. These patients were followed up in accordance with standard antenatal protocol. The diagnosis of gestational hypertension (GH) was made based on a standard institutional protocol. The changes in BMD from early to late pregnancy were compared between those with/without GH.
A total of 450 patients with complete data were analyzed. The overall incidence of GH was 4.8% (n = 22), of which 1.7% (n = 8) fulfilled the definitions of severe pre-eclampsia. A mean BMD loss of 0.0256 g/cm2 (around 4.5% of early pregnancy BMD) was demonstrable from early to late gestation. The hypertensive group has marginally higher mean BMD loss as compared to the normotensive group (0.052 vs. 0.037 g/cm2; P = 0.037). However, regression analysis models showed that early pregnancy BMD values, early pregnancy fat percentage and fat accumulation in pregnancy were significant factors affecting BMD loss during pregnancy, while GH was not in the equations.
The development of gestational hypertensive disorders apparently does not have any significant impact on BMD changes during pregnancy.
- Kaur M, Pearson D, Godber I, Lawson N, Baker P, Hosking D (2003) Longitudinal changes in bone mineral density during normal pregnancy. Bone 32:449–454 CrossRef
- Wisser J, Florio I, Neff M, Konig V, Huch R, Huch A, von Mandach U (2005) Changes in bone mineral density and metabolism in pregnancy. Acta Obstet Gynecol Scand 84:349–354
- Aguado F, Revilla M, Hernandez ER, Memdendex M, Cortes-Prieto J, Villa LF, Rico H (1998) Ultrasonographic bone velocity in pregnancy: a longitudinal study. Am J Obstet Gynecol 178:1016–1021 CrossRef
- Pluskiewicz W, Drozdzowska B, Stolecki M (2004) Quantitative ultrasound at the hand phalanges in pregnancy: a longitudinal study. Ultrasound Med Biol 30:1373–1378 CrossRef
- Guideline on Antenatal Care Part II (2008) Hong Kong College of Obstetricians and Gynaecologists, Sept 2008
- The Management of Severe Pre-eclampsia/Eclampsia (2006) Green Top Guidelines. RCOG Guideline No 10 (A) March
- Lowe SA, Brown MA, Dekker GA, Gatt S, McLintock CK, McMahon LP, Mangos G, Muller P, Paech M, Walters B (2009) Society of Obstetric Medicine of Australia, New Zealand guidelines for the management of hypertensive disorders of pregnancy 2008. Aust NZ J Obstet Gynaecol 49:242–246 CrossRef
- Bhattacharya S, Campbell DM, Liston WA, Bhattacharya S (2007) Effect of body mass index on pregnancy outcomes in nullipaorous women delivering singleton babies. BMC Public Health 7:168 CrossRef
- To WWK, Wong MWN, Leung TW (2003) Relationship between bone mineral density changes in pregnancy and maternal and pregnancy characteristics: a longitudinal study. Acta Obstet Gynecol Scand 82:820–827 CrossRef
- Morikawa H, Chough SY, Ohara N, Yamasaki M, Ueda Y, Deguchi M, Mochizuki M (1989) Pregnancy induced hypertension (PIH) and osteoporosis. Nippon Naibunpi Gakkai Zasshi 65:1123–1134
- Sowers M, Scholl T, Grewal J, Chen X, Jannausch M (2001) IGF-1, osteocalcin and bone change in pregnant normotensive and pre-eclamptic women. J Clin Endocrinol Metab 86:5898–5903 CrossRef
- Yang GU, Lewis DF, Deere K, Groome LJ, Wang Y (2008) Elevated maternal IL-16 levels, enhanced IL-16 expressions in endothelium and leukocytes, and increased IL-16 production by placental trophoblasts in women with preeclampsia. J Immunol 181:4418–4422
- McLean RR (2009) Proinflammatory cytokines and osteoporosis. Curr Osteoporos Rep 7:134–139 CrossRef
- Hofmeyr GJ, Duley L, Atallah A (2007) Dietary calcium supplementation for prevention of preeclampsia and related problems: a systematic review and commentary. Br J Obstet Gynaecol 114:933–943 CrossRef
- Nielsen TR, Rylander R (2010) Urinary calcium and magnesium excretion relates to increase in blood pressure during pregnancy. Arch Gynecol Obstet Feb [Epub ahead of print]
- Olausson H, Laskey MA, Goldberg GR, Prentice A (2008) Changes on bone mineral status and bone size during pregnancy and the influence of body weight and calcium intake. Am J Clin Nutr 88:1032–1039
- Patel R, Blake GM, Rymer J, Fogelman I (2000) Long term precision of DXA scanning assessed over seven years in forty postmenopausal women. Osteoporos Int 11:68–75 CrossRef
- To WWK, Wong MWN (2008) Bone mineral density changes in gestational diabetic pregnancies—a longitudinal study using quantitative ultrasound measurements of the os calcis. Gynecol Endocrinol 24:519–525 CrossRef
- Tranquilli AL, Giannubilo SR, Corradetti A (2004) Ultrasound measurement of pregnancy induced changes in maternal bone mass: longitudinal cross-sectional and biochemical study. Gynecol Endocrinol 18:258–262 CrossRef
- Bone mineral density changes in pregnancies with gestational hypertension: a longitudinal study using quantitative ultrasound measurements
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Archives of Gynecology and Obstetrics
Volume 284, Issue 1 , pp 39-44
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