Abstract
Reports of five young women who developed vertebral fractures associated with pregnancy and lactation are presented (Fig. 1). Ages ranged from 24 to 37 (mean 30) years. All five patients have osteoporosis with two to nine vertebral fractures at presentation postpartum. Bone mineral density (BMD) was measured by single-photon absorptiometry, quantitative computer tomography, and dual-energy X-ray absorptiometry. BMD of the trabecular bone was less than normal values and it remained apparently low even several years after pregnancy. Histological findings of bone biopsy identified the bone loss with increasing bone resorption. Our present findings suggest that postpregnancy osteoporosis affects mainly the trabecular bone site, and the patients might have low peak bone mass and poor reversibility probably due to a low rate of remodeling.
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References
Nordin BE, Roper A (1955) Post-pregnancy osteoporosis—a syndrome? Lancet 1:431–434
Jackson WPU (1958) Osteoporosis of unknown cause in younger people. J Bone Joint Surg 40[B]:420–441
Dent CE, Friedman M (1964) Pregnancy and idiopathic osteoporosis. Quart J Med 34:341–357
Gruber HE, Gutteridge DH, Baylink DJ (1984) Osteoporosis associated with pregnancy and lactation: bone biopsy and skeletal features in three patients. Metab Bone Dis Rel Res 5:159–165
Smith R, Stevenson JC, Wineaels CG, Woods CG, Wordsworth BP (1985) Osteoporosis of pregnancy. Lancet 1:1178–1180
Chung HC, Lim SK, Lee MK, Lee MH, Huh KB (1988) Pregnancy-associated osteoporosis. Yonsei Med J 29:286–294
Frost HM (1969) Tetracycline-based histological analysis of bone remodeling. Calcif Tissue Res 3:211–237
Villanueva AR (1983) Preparation and staining of mineralized sections of bone. In: Takahashi H (ed) Handbook of bone morphometry. Nishimura, Niigata, pp 45–55
Takahashi HE (1990) Labeling patterns after double bone labeling in vivo, revisited. In: Takahashi HE (ed) Bone histomorphometry. Nishimura, Niigata, pp 239–246
Hagino H, Kishimoto H, Kagawa T, Yamamoto K (1991) Single-photon absorptiometry. Bone (Japanese) 5:59–71
Fujii Y, Tsunenari T, Tsutsumi M, Miyachi A, Yamada H, Fukase M, Yoshimoto Y, Okuno Y, Kusakabe H, Miyoshi K, Fukunaga M, Morita R, Fujita T (1988) Quantitative computed tomography: comparison of two calibration phantoms. J B M M 6:71–74
Kin K, Kushida K, Yamazaki K, Okamoto S, Inoue T (1990) Bone mineral density of the spine in normal Japanese subjects. J B M M 8:53–56
Parfitt AM, Drezner MK, Glorieux FH, Kanis JA, Malluche H, Meunier PJ, Ott SM, Recker RR (1987) Bone histomorphometry: standardization of nomenclature, symbols, and units. Report of the ASBMR histomorphometry nomenclature committee. J Bone Miner Res 2:595–610
Recker RR, Kimmel DB, Parfitt AM, Davies KM, Keshawarz N, Hinders S (1988) Static and tetracycline-based bone histomorphometric data from 34 normal postmenopausal females. J Bone Miner Res 3:133–144
Konno T (1987) Age- and sex-associated histomorphometric changes in the ilium. J Jpn Orthop Assoc 61:1081–1091
Stevenson J, Hillyard C, MacIntyre I (1979) A physiological role for calcitonin: protection of the maternal skeleton. Lancet 2:769
Hillman L, Sateesha S, Haussler M, Wiest W, Slatopolsky E, Haddad J (1981) Control of mineral homeostasis during lactation: interrelationships of 25-hydroxyvitamin D, 24,25-dihydroxyvitamin D, 1,25-dihydroxyvitamin D, parathyroid hormone, calcitonin, prolactin and estradiol. Am J Obstet Gynecol 139:471–476
Nilsson BE (1969) Parity and osteoporosis. Surg Gynecol Obstet 129:27–28
Christiansen C, Rodbro P, Heini B (1976) Unchanged total body calcium in normal human pregnancy. Acta Obstet Gynecol Scand 55:141–143
Lamke B, Brundin J, Moberg P (1977) Changes of bone mineral content during pregnancy and lactation. Acta Obstet Gynecol Scand 56:217–219
Atkinson PJ, West RR (1970) Loss of skeletal calcium in lactating women. J Obstet Gynaecol Br Commonw 77:555–560
Chan GM, Ronald N, Slater P, Hollis J, Thomas MR (1982) Decreased bone mineral status in lactating adolescent mothers. J Pediatrics 101:767–770
Koetting CA, Wardlaw GM (1988) Wrist, spine, and hip bone density in women with variable histories of lactation. Am J Clin Nutr 48:1479–1481
Miller SC, Shupe JG, Redd EH, Miller MA, Omura TH (1986) Changes in bone formation rates during pregnancy and lactation in rats. Bone 7:283–287
Anderson JJB, Garner SC, Mar MH, Boass A, Toverud SU, Parikh I (1990) The ovariectomized, lactating rat as an experimental model for osteopenia: calcium metabolism and bone changes. Bone Miner 11:43–53
Miller MA, Omura TH, Miller SC (1989) Increased cancellous bone remodeling during lactation in beagles. Bone 10:279–285
Kimmel DB, Recker RR, Gallagher JC, Vaswani AS, Aloia JF (1990) A comparison of iliac bone histomorphometric data in post-menopausal osteoporotic and normal subjects. Bone Miner 11:217–235
Kimmel DB, Recker RR, Lappe JM (1992) Histomorphometry of normal pre- and post-menopausal women. In: Malluche HH (ed) (Sixth International Congress of Bone Morphometry), astract 70
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Yamamoto, N., Takahashi, H.E., Tanizawa, T. et al. Bone mineral density and bone histomorphometric assessments of postpregnancy osteoporosis: A report of five patients. Calcif Tissue Int 54, 20–25 (1994). https://doi.org/10.1007/BF00316284
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DOI: https://doi.org/10.1007/BF00316284