Pregnancy Associated Osteoporosis
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It is thought that normal pregnancy does not cause osteopenia or osteoporosis in most women. Although there is bone loss during the first 6 months of lactation, subsequent recovery is generally expected. It has been reported that women can develop pregnancy-associated idiopathic osteoporosis during pregnancy or while lactating. The cause of this is controversial, but most authorities believe that pregnancy unmasks a pre-existing bone disease. In more than one-half of pregnant women, no apparent cause for osteoporosis can be identified. Some known causes of pregnancy-associated idiopathic osteoporosis include heparin therapy, prolonged bed rest, and corticosteroid therapy. In a few cases, overt hyperparathyroidism or thyrotoxicosis eventually develops. Bone mass is the main predictor of fractures. Maximum bone-mass accumulation is reached by the end of the second decade, just before the childbearing age. Pregnancy and lactation are associated with considerable changes in calcium homeostasis to meet fetal calcium demands for skeletal calcification. Although renal conservation of calcium is less efficient during pregnancy, the active absorption of calcium by the intestine doubles by 20weeks. In theory, since there is 30～35g of calcium in the full-term neonate, and considering that the maternal skeleton contains 1,000g of calcium, the effect on the mother should be relatively slight. To help understand the effects of pregnancy on bone turnover and osteoporosis, the author has reviewed the some literature and studies have utilized biochemical markers of bone formation, resorption, and bone turnover before, during, and after pregnancy.
Abstract
It is thought that normal pregnancy does not cause osteopenia or osteoporosis in most women. Although there is bone loss during the first 6 months of lactation, subsequent recovery is generally expected. It has been reported that women can develop pregnancy-associated idiopathic osteoporosis during pregnancy or while lactating. The cause of this is controversial, but most authorities believe that pregnancy unmasks a pre-existing bone disease. In more than one-half of pregnant women, no apparent cause for osteoporosis can be identified. Some known causes of pregnancy-associated idiopathic osteoporosis include heparin therapy, prolonged bed rest, and corticosteroid therapy. In a few cases, overt hyperparathyroidism or thyrotoxicosis eventually develops. Bone mass is the main predictor of fractures. Maximum bone-mass accumulation is reached by the end of the second decade, just before the childbearing age. Pregnancy and lactation are associated with considerable changes in calcium homeostasis to meet fetal calcium demands for skeletal calcification. Although renal conservation of calcium is less efficient during pregnancy, the active absorption of calcium by the intestine doubles by 20weeks. In theory, since there is 30～35g of calcium in the full-term neonate, and considering that the maternal skeleton contains 1,000g of calcium, the effect on the mother should be relatively slight. To help understand the effects of pregnancy on bone turnover and osteoporosis, the author has reviewed the some literature and studies have utilized biochemical markers of bone formation, resorption, and bone turnover before, during, and after pregnancy.
참고문헌 (38)
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