title: Osteoporosis with vertebral fractures associated with pregnancy and lactation.
abstract: Three cases of young women who developed severe vertebral osteoporosis after pregnancy and during lactation are described. These patients shared several features: a low-calcium diet during most of their lives, very-low body weight in two patients, and a positive family history of osteoporosis in two patients. Initial studies disclosed vertebral fractures, severely diminished bone mineral density of the spine (Z score = -3.3 to -4.1), and a less severely affected bone mineral density of the hip (Z score = -1.6 to -2.3). During the prolonged follow-up of these patients, treated with oral biphosphonates, vitamin D, and calcium, an improved clinical response with a marked recovery of spine bone mineral density was observed. Poor general nutrition, low calcium intake, and a positive family history of osteoporosis appear to be strong risk factors for pregnancy- and lactation-associated osteoporosis. Although the mechanism of action is uncertain, calcium, vitamin D, and antiresorptive agents may have been beneficial in the treatment of this severe disorder.
authors: National Council of Research, Universidad de Buenos Aires, Buenos Aires, Argentina. osteologia@ciudad.com.ar
authors: S
authors: S
authors: Di Gregorio
authors: K
authors: K
authors: Danilowicz
authors: Z
authors: Z
authors: Rubin
authors: C
authors: C
authors: Mautalen
mesh_terms: D000328:Adult; D019386:Alendronate / Q000627:therapeutic use; D015519:Bone Density / Q000187:drug effects; D002118:Calcium / Q000172:deficiency / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004872:Ergocalciferols / Q000627:therapeutic use; D005260:Female; D005272:Femur Neck / Q000503:physiopathology; D006801:Humans; D007774:Lactation; D008137:Longitudinal Studies; D008159:Lumbar Vertebrae / Q000503:physiopathology; D010024:Osteoporosis / Q000150:complications / Q000209:etiology* / Q000628:therapy; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology* / Q000628:therapy; D016103:Spinal Fractures / Q000209:etiology*
chemical_list: D004872:Ergocalciferols; D002118:Calcium; D019386:Alendronate