Pregnancy and Osteoporosis – A Practical Guide by Dr. Masumi
Osteoporosis, a condition that causes bones to become more brittle, is usually not prevalent among young women. However, I have come across cases of spine fractures during pregnancy, the postpartum period, or while a woman is breastfeeding. Although the root causes of osteoporosis are poorly understood, we assume that pre-existing reductions in bone mineral density – combined with the added metabolic and mechanical stresses of pregnancy – can result in fragility fractures.
It is known that breastfeeding will cause a loss of skeletal mineral content in a mother’s body. While the mother’s bone weakness will usually decrease after the lactation period, we would like to introduce the idea of bone health during and after pregnancy.
Case Study: Mrs. B – 32-year-old accountant
Mrs. B fractured her wrist when she was 12 in a roller-skating accident. During her first pregnancy, at age 29, she had pain in her right buttock pain for two weeks, which was diagnosed as sacroiliac pain (pain of the sacrum, a bone in the hip). During her second pregnancy, she suffered from severe back pain lasting one day during her labor. At 10 weeks postpartum, she experienced more severe back pain. She could not turn over in bed and stopped breastfeeding.
An X-ray of her spine showed a spinal fracture.
Further tests also showed that her bone mass density had become very low, indicating that her bones had become osteoporotic.
It took more than six weeks of vitamin D replacement therapy and gentle weight-bearing exercises before her pain started to become more manageable.
So, how can you decrease your risk of pregnancy-related osteoporosis? For starters, you can ensure that your intake of calcium is adequate during and after your pregnancy. Calcium is crucial during this time because it is used both for calcium accretion in the fetus and because bone turnover is accelerated in a mother’s skeleton after she gives birth. Inadequate maternal calcium intake would cause marked bone loss. Mothers must provide enough calcium during and after pregnancy (about 1,000 milligrams a day) for optimal health.
Figures show that Asian women have much less calcium in their diets compared to Australian, American, and European women. This is because traditional Asian diets provide less dairy. Many women go on diets after they give birth in order to lose weight and get their figures back, but this makes new mothers’ bones markedly weaker.
Pregnancy-related osteoporosis is usually not diagnosed until after the baby is born. This is because osteoporosis itself generally doesn’t generate any symptoms until a fracture occurs, and in pregnancy-associated osteoporosis, most fractures occur during or soon after the birth. To prevent these fractures, we have set up a comprehensive bone check package at Beijing United Family Hospital. It includes a consultation with an orthopedic doctor (a bone specialist), blood tests, and a DXA scan to test your bone density. If you have experienced severe lower back pain before, or if you are taking certain medications (steroids, anti-convulsion medications, Heparin, etc), please consult with our doctors.
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