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Changes in bone density and metabolism in pregnancy.
Josef Wisser1, Ivrea Florio, Maurus Neff
1Department of Obstetrics, Zurich University Hospital, Zurich, Switzerland. josef.wisser@usz.ch
Acta Obstetricia Et Gynecologica Scandinavica
|March 15, 2005
Summary
Pregnancy impacts maternal bone density differently between individuals. Early serum osteocalcin levels can predict which women will experience significant bone loss during pregnancy.
Area of Science:
- Reproductive Endocrinology
- Bone Metabolism
- Maternal Health
Background:
- The effect of pregnancy on maternal bone density is not fully understood.
- Investigating gestational bone metabolism requires understanding changes in bone density and biochemistry.
Purpose of the Study:
- To document changes in bone metabolism biochemistry.
- To assess changes in trabecular and cortical bone density from early to late pregnancy.
Main Methods:
- Prospective study of 43 healthy women (34 pregnant).
- Peripheral quantitative computed tomography used for bone density measurements (first and third trimesters).
- Bone metabolism parameters measured: parathyroid hormone, calcitonin, osteocalcin, alkaline phosphatase, and urinary desoxypyridinoline/creatinine.
Main Results:
- Cortical bone density remained unchanged during pregnancy.
- Trabecular bone density showed significant interindividual variation, with 'fast losers' (> -3% per year) and 'slow losers' (< -3% per year).
- Lower serum osteocalcin levels in both trimesters differentiated slow from fast bone losers; it was the sole independent predictor.
Conclusions:
- Wide interindividual variation in trabecular bone density explains conflicting previous reports.
- First-trimester serum osteocalcin concentration can predict women at higher risk of trabecular bone loss.
- Osteocalcin may serve as a predictor for later bone loss and osteoporosis.