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Pregnancy-associated transient osteoporosis of the hip: results of a case-control study

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Abstract

Summary

The etiology and underlying mechanisms of transient of osteoporosis of the hip (TOH) during pregnancy are still unclear, since no systematic analyses exist. Our results support the hypothesis that TOH is a multifactorial disease, which is associated with immobility, dental problems, and lack of exercise in childhood.

Introduction

Pregnancy-associated transient osteoporosis of the hip (TOH) is a rare but severe form of osteoporosis, which may affect a subgroup of women in the last trimester of pregnancy or immediately postpartum. Common symptoms include acute pain of the hip(s) due to bone marrow edema or even hip fractures. The exact underlining mechanisms of this disorder are still unknown since no published systematic analyses exist.

Methods

Out of a total of 52 TOH patients, 33 TOH patients could be matched with 33 healthy controls according to age, region, and gravity. The aim of this retrospective case-control study was to evaluate the risk factors for TOH in a homogenous population of women.

Results

The baseline characteristics of the two study groups were similar. Overall, 12.1% of the TOH patients sustained a hip fracture. Expectedly, 90.9% of the TOH patients complained about pain of the hip (p ≤ 0.001). TOH patients suffered more frequently from severe dental problems during childhood (p = 0.023) and performed less often sports before and after puberty (p ≤ 0.001), whereas the frequency of immobilization during pregnancy was threefold higher compared to the control group (p = 0.007). We found a significant increase of the TOH risk in patients with dental problems in childhood (OR 3.7; CI 1.3–10.7) as well as in patients with lack of exercise during childhood (OR 4.2; CI 1.3–12.9).

Conclusions

Our results support the hypothesis that pregnancy-associated TOH is a multifactorial disease, to which several individual factors may contribute. Hereby, we found significant associations with immobility, dental problems, and lack of exercise in childhood.

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Author information

Authors and Affiliations

  1. Department of Bone Oncology, Gynecological Endocrinology and Reproductive Medicine, German Reference Centre for Pregnancy-Associated Osteoporosis, Nordwest Hospital Frankfurt, Steinbacher Hohl 2-26, 60488, Frankfurt a. M, Germany

    Peyman Hadji

  2. Faculty of Medicine, Philipps-University of Marburg, Marburg, Germany

    Peyman Hadji, Lars Hellmeyer & Ioannis Kyvernitakis

  3. Department of Obstetrics and Gynecology, Philipps-University of Marburg, Marburg, Germany

    Jelena Boekhoff & Melitta Hahn

  4. Department of Obstetrics and Gynecology, Vivantes Klinikum Friedrichshain, Berlin, Germany

    Lars Hellmeyer

  5. Statistical Institute Dr. Hars, Berlin, Germany

    Olaf Hars

  6. Department of Obstetrics and Gynecology, Buergerhospital Frankfurt, Goethe-University of Frankfurt, Frankfurt, Germany

    Ioannis Kyvernitakis

Authors
  1. Peyman Hadji
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  2. Jelena Boekhoff
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  3. Melitta Hahn
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  4. Lars Hellmeyer
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  5. Olaf Hars
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  6. Ioannis Kyvernitakis
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Corresponding author

Correspondence to Peyman Hadji.

Ethics declarations

The local ethics committee of the Philipps University of Marburg approved the study. All patients provided written informed consent prior to participation according to the Declaration of Helsinki and the German law.

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Hadji, P., Boekhoff, J., Hahn, M. et al. Pregnancy-associated transient osteoporosis of the hip: results of a case-control study. Arch Osteoporos 12, 11 (2017). https://doi.org/10.1007/s11657-017-0310-y

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  • DOI: https://doi.org/10.1007/s11657-017-0310-y

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