Pregnancy and Lactation Induced Osteoporosis: A Social-Media Based Survey

Background:

Pregnancy and lactation induced osteoporosis (PLO) presenting as spinal fractures is rare. The spectrum of clinical presentation, risk factors and pathophysiology are incompletely understood.

Aim:

To delineate clinical parameters in women with PLO, and to compare risk factors and osteoporosis-related quality of life with a control group.

Methods:

Participants of a social-media (WhatsApp) PLO group were offered a questionnaire, including osteoporosis-related quality of life section (MINI OQLQ). Mothers of young children in parent WhatsApp groups were approached to serve as random controls.

Results:

Twenty-four patients with PLO and 43 controls (36.9±4.8vs38.8±4.3y.o.,p=0.11) replied. More than 5 vertebrae were involved in 50%, 4 in 25% and 3 or less in 25%. 85.7% of the fractures were a-traumatic. Nineteen percent of the fractures occurred during pregnancy and others, during early postpartum period. Diagnosis was delayed for over 16 weeks in 41.8% of women. 62.5% received teriparatide. A significantly lower proportion of women in the PLO group engaged in physical activity over 2 hours/week during pregnancy (37.5vs86.3%,p<0.05). Seventy-one percent of the PLO patients expressed fear of fractures and 58.3% fear of falls compared to none and 2.3%, respectively (p<0.01) of the controls.

Conclusions:

PLO-related spinal fractures involve multiple vertebrae in the majority of the affected women, and the diagnosis is delayed. Less physical activity might pose a risk. Most of PLO patients in our cohort were treated with teriparatide. PLO patients reported a significant impairment of quality of life. Multidisciplinary effort should be exerted to early identification and treatment of this severe condition.