Pregnancy-related fractures: a retrospective study of a French cohort of 52 patients and review of the literature.
A retrospective, multicentre study involving 52 patients was carried out to define the causes and characteristics of pregnancy-related osteoporosis. The mean number of vertebral fractures occurring during the last trimester of pregnancy or at the time of delivery was 3.8. This is often promoted by risk factors before or during pregnancy.


INTRODUCTION
In order to define the causes or predisposing factors of pregnancy-related osteoporosis and its clinical, radiological and bone density characteristics, laboratory findings, course and outcome, we carried out a retrospective multicentre study.


METHODS
The records of 52 women hospitalised over the last 10 years in the rheumatology departments of six French university hospitals and with a diagnosis of pregnancy-related osteoporosis were examined.


RESULTS
The patients' mean age at time of fracture was 32.1 years. In 10 patients, the fractures had occurred during the last trimester of pregnancy, and in 36 at the time of delivery or during the first 2 months post-partum. The mean number of vertebral fractures was 3.8 ± 2.0. Thirty three of the 52 patients had a risk factor of low bone mass before pregnancy. Twelve had disorders or treatments (heparin) that might promote osteoporosis during pregnancy, while 14 had no trigger factors before or during pregnancy. Overall, phosphate and calcium levels were normal, except for hyperphosphoraemia in lactating women (90%). On DXA scan, osteoporosis predominated in the trabecular bone (spinal T-score - 3.4, hip T-score - 2). Only 10 patients had a repeat fracture, and the increase in bone mineral density during follow-up was considerable, and improved by bisphosphonates (annual gain + 10% in the spine) or teriparatide (+ 15%).


CONCLUSIONS
Pregnancy-related osteoporosis gives rise to multiple vertebral fractures. It is often promoted by risk factors before or during pregnancy. Its mechanism is still unknown. Treatment with bisphosphonates or teriparatide appears to improve the recovery of bone mineral density.
['Laroche|M|M|', 'Talibart|M|M|', 'Cormier|C|C|', 'Roux|C|C|', 'Guggenbuhl|P|P|', 'Degboe|Y|Y|']
D015502:Absorptiometry, Photon D000328:Adult D015519:Bone Density D050071:Bone Density Conservation Agents D005260:Female D006801:Humans D008875:Middle Aged D010024:Osteoporosis D011247:Pregnancy D011248:Pregnancy Complications D012189:Retrospective Studies D012307:Risk Factors D016103:Spinal Fractures D055815:Young Adult
Osteoporosis Vertebral fractures Pregnancy Risk factors