PREGNANCY-ASSOCIATED OSTEOPOROSIS

OBJECTIVE Previous literature reports have suggested that osteoporosis associated with pregnancy is a rare event. We have examined the preva lence of this condition and compiled data on the largest group of such patients in the literature. PATIENTS AND DESIGN With the help of the National Osteoporosis Society 35 women with pregnancy associated osteo porosis were identified. These women were matched with a control group from our already established computer data bank for age, weight, heig ht and calcium status. Detailed questionnaires were sent to the osteop orotic sufferers enquiring about their present condition, past medical and drug history, and their menstrual, lactational and obstetric hist ories. They were also asked to complete a detailed dietary history to establish their calcium status. A questionnaire was also completed by the parents of these women and the parents of the control group, askin g specifically about fracture history. RESULTS Twenty-nine women had i diopathic osteoporosis associated with pregnancy, while in six, the co ndition may have resulted from drug therapy or associated diseases. Pa in occurring late in the first full term pregnancy was the most common presentation. The natural history was for the condition to improve wi th time. There was a significantly higher prevalence of adult related fractures (P<0.02) occurring at an earlier age in the mothers of these women compared to a control population. CONCLUSION We have identified 35 women who have developed osteoporosis during or shortly after preg nancy and in only six of them could a recognized underlying cause be s uggested. These findings would suggest that idiopathic osteoporosis as sociated with pregnancy may be more common than the current literature suggests. The higher prevalence of fractures in the mothers of our po pulation compared to controls raises the question of a possible associ ated genetic tactor in the aetiology of this condition.