title: Influence of pregnancy on bone density: a risk factor for osteoporosis? Measurements of the calcaneus by ultrasonometry.
abstract: BACKGROUND
  There are conflicting opinions in the literature about whether pregnancy influences maternal bone density or osteoporosis development. The study aim was to investigate whether there is a significant alteration in maternal bone density during normal pregnancy.
  
  
  METHODS
  Bone mass of 200 pregnant women aged 22-42 years was measured twice with quantitative ultrasonometry (QUS) of the heel (Os calcaneum). The first measurement was performed between the 10th and 22nd week of pregnancy, follow-up of 149 women took place 0-9 days postpartum. A questionnaire focusing on data affecting bone metabolism and bone turnover was handed out at the first visit.
  
  
  RESULTS
  Median reduction in speed of sound (SOS) was 11 m/s at follow-up indicating a decline of the stiffness during pregnancy. No significant correlation was found between lactation period and the obtained values for stiffness, SOS, T score and Z score. For broadband ultrasonographic attenuation, there was a statistically significant difference (p < 0.05) between women who had and had not breastfed. Parameters from patients with a family history of osteoporosis (n = 30) compared to patients without did not reveal statistical significance during pregnancy. Glucocorticoid therapy, nicotine consumption, physical exercise and nutrition was not statistically significant (p > 0.05). SOS value of women with a twin pregnancy was different over the study period (p < 0.05).
  
  
  CONCLUSIONS
  A reduction in bone mass is possible during pregnancy. Routine evaluation of the bone density in all pregnant women does not seem to be justified; however, it is reasonable in women who present with risk factors. These women could be screened with QUS.
authors.affiliation: University Hospital for Women, University of Tuebingen, Calwerstr. 7, 72076 Tuebingen, Germany. Bernhard.Kraemer@med.uni-tuebingen.de
authors.forename: Bernhard
authors.initials: B
authors.lastname: Kraemer
authors.forename: Silke
authors.initials: S
authors.lastname: Schneider
authors.forename: Ralf
authors.initials: R
authors.lastname: Rothmund
authors.forename: Tanja
authors.initials: T
authors.lastname: Fehm
authors.forename: Diethelm
authors.initials: D
authors.lastname: Wallwiener
authors.forename: Erich-Franz
authors.initials: EF
authors.lastname: Solomayer
mesh_terms: D000328:Adult; D015519:Bone Density / Q000502:physiology*; D002111:Calcaneus / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D010024:Osteoporosis / Q000209:etiology*; D011247:Pregnancy / Q000502:physiology*; D012307:Risk Factors; D014463:Ultrasonography; D055815:Young Adult