Quantitative ultrasound at the hand phalanges in pregnancy: a longitudinal study

In the prospective study, 48 females in normal pregnancy were evaluated to determine if the presence of disturbances of maternal bone and mineral status is related to fetal and newborn growth. The aim of the study was to estimate mean and individual changes in maternal skeletal and laboratory variables during pregnancy and their correlations with fetal and newborn sizes. Maternal bone and mineral status was assessed in first, second and third trimester by quantitative ultrasound (US), or QUS, at the hand phalanges (Ad-SoS [m/s]) performed by DBM Sonic 1200 (IGEA, Carpi, Italy) and laboratory investigations were collected (serum total calcium, total alkaline phosphatase and phosphate). The hypothesis that fetus growth and sizes of the newborn may have an influence on bone and mineral status in pregnancy was tested by the correlation of ultrasonographic fetal measurements and newborn sizes with changes in maternal QUS and biochemical data. Ad-SoS decreased significantly (p < 0.00001) and alkaline phosphatase increased significantly in second and third trimester of pregnancy (p < 0.01). A decrease in Ad-SoS greater than least significant change (LSC) was observed in 22 females (46%) during pregnancy. Changes in alkaline phosphatase correlated significantly with changes in Ad-SoS (r = -0.31, p < 0.05). Fetal ultrasonographic measurements (femur length and biparietal diameter) correlated significantly with changes in alkaline phosphatase (r ranged 0.31 to 0.56, p < 0.05). No significant correlations were observed between fetal ultrasonographic measurements (femur length and biparietal diameter) and newborn size with changes in Ad-SoS. In conclusion, the study revealed considerable changes in maternal bone and mineral status in normal pregnancy.