[Epidemiology and pathophysiology of post-pregnancy osteoporosis.]

Clinical calcium Pub Date : 2019-01-01 DOI:CliCa19013945
Takumi Kurabayashi, Kyoko Morikawa
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Abstract

Post-pregnancy osteoporosis is a rare condition with little known pathophysiology. Most cases are diagnosed in the late stage of pregnancy or in the post partum while breastfeeding, particularly in first pregnancy. Non-traumatic vertebral fragility fractures are most commonly observed and characterized by prolonged severe pain and functional limitations. Conventional radiography will confirm the fracture in most cases, and magnetic resonance, which can be safely used during pregnancy, is effective in detecting vertebral fractures and bone marrow edema. It is important to exclude secondary osteoporosis, e.g. endocrine diseases, chronic liver and kidney diseases, autoimmune diseases, genetic diseases, drugs and malignant tumors. The prevalence of post-pregnancy osteoporosis is unknown, and may be estimated more than 3 for every ten thousand pregnant women. The pathophysiology of post-pregnancy osteoporosis is also unknown. The physiological bone resorption during reproduction does not normally cause fracture;instead, women who do fracture may be more likely to have additional secondary causes of bone loss and fragility, e.g. low body weight, low peak bone mass, malnutrition and heredity.

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妊娠后骨质疏松的流行病学和病理生理。
妊娠后骨质疏松症是一种罕见的疾病,其病理生理机制鲜为人知。大多数病例是在妊娠晚期或哺乳期间的产后诊断出来的,特别是在第一次怀孕时。非创伤性椎体脆性骨折是最常见的,其特征是长时间的剧烈疼痛和功能限制。在大多数情况下,常规的x线摄影可以确认骨折,而在怀孕期间可以安全使用的磁共振在检测椎体骨折和骨髓水肿方面是有效的。排除继发性骨质疏松症,如内分泌疾病、慢性肝肾疾病、自身免疫性疾病、遗传性疾病、药物和恶性肿瘤。妊娠后骨质疏松症的患病率尚不清楚,估计每万名孕妇中有3人以上患骨质疏松症。妊娠后骨质疏松的病理生理机制也不清楚。生育期间的生理性骨吸收通常不会导致骨折;相反,发生骨折的妇女可能更有可能有其他继发性原因导致骨质流失和脆弱,例如体重过轻、骨量峰值过低、营养不良和遗传。
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