Clinical characteristics of osteoporosis associated with pregnancy and lactation, risk factors

Objective: Osteoporosis associated with pregnancy and lactation (APL) is a rare disease, the exact pathophysiological mechanisms of which remain largely unknown. Aim: to analyze the clinical features of osteoporosis associated with pregnancy and lactation and to study risk factors for the disease. Materials and methods: The study involved 27 women aged 18 to 40 years, with complaints of back pain that first appeared during pregnancy and/or lactation, in the presence of a confirmed vertebral fracture on MRI or a decrease in Z, T-criteria (-2.5) for X-ray densitometry. The control group consisted of 14 women without fractures and a history of complaints of back pain. The patient underwent imaging studies: MRI, dual-energy X-ray absorptiometry (DEXA), biochemical blood test, bone markers. Results: Bone fractures were observed mainly during pregnancy and lactation. 11 (40.7%) patients had a fracture during the 1st pregnancy, 5 (18.5%) patients had a fracture during the 2nd pregnancy, the same number (5 - 18.5%) patients - during the 3rd pregnancy, in 2 (7.4%) patients - during the 4th pregnancy. No fractures were observed in 4 (14.8%) patients. Thus, in the main group, insignificantly, but more (55.6%; OR 14.3; 95%CI 2.58-78.8; p <0.001) women who either did not take or did not regularly consume in the daily diet foods high in calcium compared to the control (35.7%). Significantly fewer women (29.6%) engaged in physical activity for at least 30 minutes than the control group (85.7%; OR 0.07; 95%CI 0.1-0.39; p<0.001). Conclusion: The data obtained demonstrate that a decrease in BMD to osteopenia values was observed in the hip (right-70.4%, left - 55.6%) and femoral neck (right - 40.7%, left - 51.9%) majority examined women.