scholarly journals Pregnancy- and lactation-associated osteoporosis with vertebral fractures: a systematic review

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ying Qian ◽  
Lei Wang ◽  
Lili Yu ◽  
Weimin Huang
Keyword(s):  
Back Pain ◽  
Vertebral Fractures ◽  
Data Extraction ◽  
Treatment Options ◽  
Osteoporotic Fractures ◽  
Late Pregnancy ◽  
Mean Value ◽  
Thoracolumbar Region ◽  
Pregnancy And Lactation ◽  
Z Scores

Abstract Background To review, analyze and characterize the pregnancy and lactation-related osteoporosis (PLO) with vertebral fractures based on the extraction data in the previous studies. Methods A comprehensive literature search of electronic databases including the PubMed, Embase and Web of Science was conducted from January 1st,1990 to December 1st, 2020. The enrolled data were pooled to analyze the baseline characteristics, clinical features, risk factors and treatment options. Results A total of 65 articles with 338 cases were enrolled for data extraction. The enrolled cases aged from 19 to 47 years, with a mean value of 35.7 years old. The average body mass index (BMI) was 22.2 kg/m2 ranged from 16.0 to 39.0 kg/m2. Of the 173 cases, 149 cases with vertebral fractures occurred in the first pregnancy, 19 cases in the second pregnancy, four cases in the third pregnancy and one case in the fourth pregnancy. Up to 91.5% of the back pain occurred within the last 3 months of pregnancy and the first 3 months after delivery. The most involved vertebral levels were L2, L1 and T12 accounting for 32.6% of all the fractures. The average fracture numbers were 4.4 levels per patient. The lumbar Z-scores were mostly recorded with a mean value of − 3.2 ranged from − 7.8 to 0. Conclusions PLO with vertebral fractures is a rare clinical entity, which is more likely to occur in older and thinner pregnant women. Back pain is the clinical complaint and mostly occurs in the late pregnancy and early lactation periods. Most vertebral fractures appear in the first pregnancy but it can occur in any time of pregnancy. Thoracolumbar region is the mostly involved region. As compared with postmenopausal osteoporotic fractures, PLO usually has multiple levels fractures. Bisphosphonates are the most widely used treatment so far, however, many factors need to be taken into account to decide which drug to choose in PLO and further studies are necessary for clear recommendation in the future.

scholarly journals Pregnancy- and Lactation-associated Osteoporosis with Vertebral Fractures: A Systematic Review

2021 ◽  
Author(s):  
Ying Qian ◽  
Lei Wang ◽  
Lili Yu ◽  
Weimin Huang
Keyword(s):  
Back Pain ◽  
Vertebral Fractures ◽  
Data Extraction ◽  
Treatment Options ◽  
Osteoporotic Fractures ◽  
Late Pregnancy ◽  
Mean Value ◽  
Thoracolumbar Region ◽  
Pregnancy And Lactation ◽  
Z Scores

Abstract Backgroud: To review, analyze and characterize the pregnancy and lactation-related osteoporosis (PLO) with vertebral fractures based on the extraction data in the previous studies. Methods: A comprehensive literature search of electronic databases including the PubMed, Embase and Web of Science was conducted from January 1st,1990 to December 1st, 2020. The enrolled data were pooled to analyze the baseline characteristics, clinical features, risk factors and treatment options. Results: A total of 65 articles with 338 cases were enrolled for data extraction. The enrolled cases aged from 19 to 47 years, with a mean value of 35.7 years old. The average body mass index (BMI) was 22.2kg/m2 ranged from 16.0 to 39.0 kg/m2. Of the 173 cases, 149 cases with vertebral fractures occurred in the first pregnancy, 19 cases in the second pregnancy, four cases in the third pregnancy and one case in the fourth pregnancy. Up to 91.5% of the back pain occurred within the last three months of pregnancy and the first three months after delivery. The most involved vertebral levels were L2, L1 and T12 accounting for 32.6% of all the fractures. The average fracture numbers were 4.4 levels per patient. The lumbar Z-scores were mostly recorded with a mean value of -3.2 ranged from -7.8 to 0. Conclusions: PLO with vertebral fractures is a rare clinical entity, which is more likely to occur in older and thinner pregnant women. Back pain is the clinical complaint and mostly occurs in the late pregnancy and early lactation periods. Most vertebral fractures appear in the first pregnancy but it can occur in any time of pregnancy. Thoracolumbar region is the mostly involved region. As compared with postmenopausal osteoporotic fractures, PLO usually has multiple levels fractures. Bisphosphonates are the most widely used treatment so far, but teriparatide has become an effective alternative to bisphosphonates.

scholarly journals Pregnancy and lactation associated osteoporosis: unrecognized cause of musculoskeletal pain syndrome during the peri-pregnancy period

2017 ◽  
Vol 6 (7) ◽  
pp. 3160
Author(s):  
Anna Kornete ◽  
Ingvars Rasa ◽  
Maija Mukane
Keyword(s):  
Musculoskeletal Pain ◽  
Post Partum ◽  
Treatment Strategies ◽  
Osteoporotic Fractures ◽  
Pain Syndrome ◽  
Late Pregnancy ◽  
Rare Disorder ◽  
Pregnancy And Lactation ◽  
Post Partum Period ◽  
Clinical Cases

Pregnancy- and lactation-associated osteoporosis (PLO) is a rare disorder, usually occurring in late pregnancy and the early post-partum period. The prevalence, etiology, pathogenesis and therapy remains unclear. Three clinical cases of PLO present patients with multiple severe osteoporotic fractures during the peri-pregnancy period and different treatment strategies.

scholarly journals Association of Incident, Clinically Undiagnosed Radiographic Vertebral Fractures With Follow-Up Back Pain Symptoms in Older Men: the Osteoporotic Fractures in Men (MrOS) Study

2017 ◽  
Vol 32 (11) ◽  
pp. 2263-2268 ◽  
Author(s):  
Howard A Fink ◽  
Stephanie Litwack-Harrison ◽  
Kristine E Ensrud ◽  
Jian Shen ◽  
John T Schousboe ◽  
...  
Keyword(s):  
Back Pain ◽  
Vertebral Fractures ◽  
Osteoporotic Fractures ◽  
Older Men ◽  
Pain Symptoms

scholarly journals Pregnancy- and lactation-associated osteoporosis with vertebral fractures

2021 ◽  
pp. 38-38
Author(s):  
Aleksandar Bozovic ◽  
Zlatan Elek ◽  
Petar Jovanovic ◽  
Dejan Tabakovic ◽  
Nenad Milosevic ◽  
...  
Keyword(s):  
Vitamin D ◽  
Back Pain ◽  
Vertebral Fractures ◽  
Pathophysiological Mechanism ◽  
Mineral Density ◽  
Pregnancy And Lactation ◽  
Vertebral Bodies ◽  
Magnetic Resonance Imaging Mri ◽  
The Stability

Introduction. Pregnancy- and lactation- associated osteoporosis (PLO) is a rare disease for which the pathophysiological mechanism is as yet incompletely known. The incidence of PLO is 0.4 in 100,000 women. It is considered that the number of undiagnosed patients is even higher. PLO can lead to multiple fragility compression fractures in the spinal vertebrae. Case outline. We present the case of a 30 years old woman (first-born, breastfeeding child) who comes for examination due to lower back pain that occurs after childbirth without any apparent cause. The patient was found to have low levels of vitamin D and low bone mineral density on osteodensitometry (established osteoporosis). Magnetic resonance imaging (MRI) examination showed vertebral bodies fractures Th11, Th12 and L4. In therapy we used Vitamin D (800 iu/24 h), Alendronate (70 mg once weekly), calcium 1000 mg/24h and Thoracic Lumbar Sacral Orthosis (TLSO) as support to spine. After 12 months of treatment osteodensitometry findings were close to normal, control MRI showed no further collapse of vertebral bodies and clinical examination of spine was orderly. Conclusion. PLO is a rare clinical condition and it must be kept in mind in the differential diagnosis in patients having low back pain during or after pregnancy. Early diagnosis and treatment of PLO and regular follow-up of these cases are particularly important. The stability of the spine in patients with vertebral fractures must be carefully monitored as well as using the TLSO as a support for the spine.

scholarly journals SAT0179 Back pain and disability before, and after, clinically-diagnosed vertebral fractures

2001 ◽  
Author(s):  
M Nevitt ◽  
L Palermo ◽  
D Thompson ◽  
D Bauer ◽  
K Stone ◽  
...  
Keyword(s):  
Back Pain ◽  
Vertebral Fractures ◽  
Before And After

scholarly journals Personalized treatment options for chronic diseases using precision cohort analytics

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kenney Ng ◽  
Uri Kartoun ◽  
Harry Stavropoulos ◽  
John A. Zambrano ◽  
Paul C. Tang
Keyword(s):  
Decision Making ◽  
Chronic Diseases ◽  
Primary Care Physicians ◽  
Treatment Guidelines ◽  
Point Of Care ◽  
Data Extraction ◽  
Treatment Options ◽  
Personalized Treatment ◽  
Medical Decision ◽  
Similarity Model

AbstractTo support point-of-care decision making by presenting outcomes of past treatment choices for cohorts of similar patients based on observational data from electronic health records (EHRs), a machine-learning precision cohort treatment option (PCTO) workflow consisting of (1) data extraction, (2) similarity model training, (3) precision cohort identification, and (4) treatment options analysis was developed. The similarity model is used to dynamically create a cohort of similar patients, to inform clinical decisions about an individual patient. The workflow was implemented using EHR data from a large health care provider for three different highly prevalent chronic diseases: hypertension (HTN), type 2 diabetes mellitus (T2DM), and hyperlipidemia (HL). A retrospective analysis demonstrated that treatment options with better outcomes were available for a majority of cases (75%, 74%, 85% for HTN, T2DM, HL, respectively). The models for HTN and T2DM were deployed in a pilot study with primary care physicians using it during clinic visits. A novel data-analytic workflow was developed to create patient-similarity models that dynamically generate personalized treatment insights at the point-of-care. By leveraging both knowledge-driven treatment guidelines and data-driven EHR data, physicians can incorporate real-world evidence in their medical decision-making process when considering treatment options for individual patients.

scholarly journals Interaction of late pregnancy and lactation in rats

Reproduction ◽  
1999 ◽  
Vol 115 (2) ◽  
pp. 341-347 ◽  
Author(s):  
T. R. Koiter ◽  
H. Moes ◽  
N. Valkhof ◽  
S. Wijkstra
Keyword(s):  
Late Pregnancy ◽  
Pregnancy And Lactation

scholarly journals SAT0600 Usefulness of vertebroplasty in vertebral fractures with persistant back pain. a report of 64 vertebral augmentation from a university hospital

2017 ◽  
Author(s):  
O Fernandez-Berrizbeitia ◽  
M González-de-Garay-Sanzo ◽  
A Lόpez-Medina ◽  
M García-Vivar ◽  
E Ruíz-Lucea ◽  
...  
Keyword(s):  
Back Pain ◽  
Vertebral Fractures ◽  
University Hospital ◽  
Vertebral Augmentation

scholarly journals A Rare Cause of Postpartum Low Back Pain: Pregnancy- and Lactation-Associated Osteoporosis

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Rabia Terzi ◽  
Hasan Terzi ◽  
Tülay Özer ◽  
Ahmet Kale
Keyword(s):  
Risk Factors ◽  
Low Back Pain ◽  
Back Pain ◽  
Fragility Fractures ◽  
Low Back ◽  
Rare Form ◽  
Current Case ◽  
Pregnancy And Lactation ◽  
Significant Disability ◽  
Appropriate Therapy

Pregnancy- and lactation-associated osteoporosis (PLO) is a rare form of osteoporosis. It results in severe low back pain in the last trimester of pregnancy and in the postpartum period, decreases in height, and fragility fractures, particularly in the vertebra. The current case report presents a 32-year-old patient who presented with back and low back pain that began in the last trimester of the pregnancy and worsened at two months postpartum and who was diagnosed with pregnancy- and lactation-associated osteoporosis after exclusion of other causes; the findings are discussed in view of the current literature. PLO is a rare clinical condition causing significant disability. PLO must be kept in mind in the differential diagnosis in patients presenting with low back pain during or after pregnancy. The patients must be evaluated for the risk factors of PLO, and an appropriate therapy must be initiated.

Sign in / Sign up

Export Citation Format

Share Document