Osteoporosis related to pregnancy is characterised by lower bone density in the third trimester or postpartum period. Affected women complain of back pain, loss of height and vertebral fractures. At times, even hip pain and fracture of the femur have also been reported. Osteoporosis generally occurs in the first pregnancy and does not recur.
There is always a lack of clarity regarding its actual cause when it strikes during pregnancy. Doctors always analyse whether any medical condition or patient’s pre-disposition to osteoporosis is the cause or not. It must be borne in mind that calcium absorption in the intestine is altered in the third trimester of pregnancy. Besides, with the skeletal development of the foetus in the third trimester and hormonal changes in the body for lactatiom, a lot of calcium gets used up during this time.
Complications related to pregnancy occur because of strain on maternal calcium stores and rise in urinary calcium excretion. The intestinal absorption of calcium is likewise increased in the second and third trimesters. The body also produces more calcium in the body by increasing the vitamin D levels. There are some physiologic changes in the body during pregnancy that may actually protect the bone. The estrogen surge that occurs in the third trimester or increased bone loading resulting from weight gain help to improve bone density.
Studies have confirmed that in many cases, pregnancy is the actual cause of osteoporosis and not any pre-existing medical condition, such as glucocorticoid exposure or heparin. Patients who did not show any risk factors of the disease before pregnancy were found to suffer from it after getting pregnant, particularly in the third trimester. Genetic factors have also been found to play their part in bringing about this disorder. Mothers of patients suffering from this condition had more fractures than others.
Most pregnant women diagnosed of osteoporosis are breastfeeding at the time of medical examination. Bone density is reduced by 3 to 5 percent in the lumber region. Increased calcium demand from the mother’s bone and elevated levels of the prolactin hormone due to breastfeeding cause loss of bone. Although, bone loss is noted by breastfeeding women, it has also been observed that such a loss is made up within 6 months of stopping the breastfeed. The bone density is back to normal in this period.
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