Ultrasound-diagnosed puerperal osteopenia in young primiparas.
OBJECTIVE
To study whether osteopenia occurs following pregnancy and to evaluate its severity in young primiparas.


METHODS
A prospective case control study. Sixty-one young primigravidae early after birth and 59 nulligravidae matched for age and BMI participated in the study. Bone status was examined using ultrasonic bone transmission velocity over the tibia; Z-score and T-score for bone density were calculated. Serum bone alkaline phosphatase, osteocalcin and urinary N-telopeptide crosslinks were evaluated as bone remodeling biochemical markers.


RESULTS
Ultrasonic parameters of bone status following delivery were significantly lower in the puerperal group as compared to the nulligravida group. Serum mean bone alkaline phosphatase levels and urinary N-telopeptide crosslinks secretion were higher by 50% in the puerperal group, while serum osteocalcin levels were significantly lower (by 25%) than in the nulligravida controls. A positive correlation between ultrasonic measurements and biochemical markers was demonstrated in the postpartum group, whereas the control group showed a negative correlation.


CONCLUSIONS
Women at their early puerperium demonstrate a significant cortical bone mass reduction as measured by ultrasonograph and markers of bone turnover. It appears that pregnancy is a state of unbalanced accelerated bone turnover that may be associated with reduced osteoblastic activity.
Feigenberg
Tomer
T
Department of Obstetrics and Gynecology, Laboratory of Experimental Surgery, Hadassah Hebrew University Medical Center, Ein-Kerem, Jerusalem, Israel. feigenberg@013.net
Ben-Shushan
Avi
A
Daka
Khaula
K
Klein
Benjamin Y
BY
Bloom
Ronald A
RA
Rojansky
Nathan
N
D000328:Adult; D000469:Alkaline Phosphatase / Q000097:blood; D015415:Biomarkers / Q000032:analysis; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000175:diagnosis*; D016022:Case-Control Studies; D024042:Collagen Type I / Q000652:urine; D005260:Female; D006801:Humans; D015675:Osteocalcin / Q000097:blood; D010298:Parity; D010455:Peptides / Q000652:urine; D011247:Pregnancy; D011446:Prospective Studies; D011644:Puerperal Disorders / Q000175:diagnosis*; D013977:Tibia / Q000000981:diagnostic imaging*; D014463:Ultrasonography
D015415:Biomarkers; D024042:Collagen Type I; D010455:Peptides; C052929:collagen type I trimeric cross-linked peptide; D015675:Osteocalcin; D000469:Alkaline Phosphatase