Pregnancy Associated Osteoporosis


Pregnancy Associated OsteoporosisOsteoporosis associated with pregnancy is a rare condition when bones break/fracture suddenly or severe pain occurs during or soon after pregnancy in otherwise apparently healthy women. These fractures can occur in the spine or occasionally the hip and result in pain and disability. Coping with fractures alongside the demands of a new baby can be particularly difficult for those affected.
 

Pregnancy-associated osteoporosis tends to be identified in the postpartum period (56%) or the third trimester (41%). Also, symptoms occurred most often in the first pregnancy (17 patients) at a mean age of 27 years (range 21-36); the most frequent was back pain in late pregnancy or post partum (n = 18); less common was hip (n = 5) or ankle (n = 1) pain.








 


 

Osteoporosis is defined by the World Health Organization (WHO) as a bone mineral density of 2.5 standard deviations or more below the mean peak bone mass (average of young, healthy adults) as measured by dual-energy X-ray absorptiometry; the term "established osteoporosis" includes the presence of a fragility fracture.
Possible Causes:

Pregnancy-associated osteoporosis is believed to occur because of the stress on maternal calcium stores and an increase in urinary calcium excretion. Factors that may cause this condition, such as genetic factors or steroid use, are being studied. Even though there is stress on a pregnant woman�s calcium supply and calcium excretion is increased by frequent urination, other changes during pregnancy, like increases in estrogen and weight gain, may actually help bone density.

Treatment & Management

Patients identified as at risk for osteoporosis should undergo preventive measures, including,

  • Pregnancy Associated OsteoporosisAdequate calcium intake:  If you do not consume enough calcium to sustain the needs of your developing baby, your body will take calcium from your bones, decreasing your bone mass and putting you at risk for osteoporosis. Osteoporosis initiates dramatic thinning of the bone, resulting in weak, brittle bones that can easily be broken. The U.S. Recommended Daily Allowance (USRDA) for calcium is 1200 milligrams (mg) per day for pregnant and lactating (breastfeeding) women over age 24. The USRDA for women under age 24 is 1200 to 1500 mg. of calcium per day.

  • Vitamin D intake: Vitamin D will help your body use calcium. Adequate amounts of Vitamin D can be obtained through exposure to the sun and in eggs, fish, and fortified milk, and

  • Exercise:  Do exercises that strengthen your back extensors. Strong back extensors help reduce the incidence of fracture. It would be best to get professional instruction. Avoid spinal flexion exercises such as abdominal crunches, sit-ups, knee-to-chest, toe-touches etc. These have been shown to dramatically increase risk of fracture. Before beginning an exercise program, we recommend discussing guidelines for safety with your healthcare provider.

  • Pregnancy Associated OsteoporosisPractical Living: Be extremely careful how you lift things. It is very important to keep objects as close to your body as possible when lifting them and of course, try to keep your back straight. Lifting things out away from your body increases the pressure on your spine exponentially.

  • Avoid tobacco use:  Cigarettes contain many chemicals that cross the placenta into the developing baby�s blood. Smoking and exposure to second-hand smoke during pregnancy can harm your developing baby's growth, and can cause miscarriage, stillbirth, preterm birth, low birth weight, and other problems for you and your baby.

  • Identify and treat alcoholism: Drinking alcohol during pregnancy can result in lifelong disabilities for your child called Fetal Alcohol Spectrum Disorder (FASD). Children with FASD have problems with hearing, speech and vision, learning problems, poor memory, and poor coordination. They also have difficulty handling emotions. Also, alcohol provides calories with little nutrition. It is never too late to quit or cut down.

Pregnancy associated osteoporosis is temporary and can be corrected with due care.

 

Dated 16 May 2013

 

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