妊娠和哺乳期相关的骨质疏松症是一种罕见且通常严重的骨质疏松症。关于病因的信息很少,临床特征,危险因素和严重程度的预测因素。使用匿名问卷,我们定义了包括初产妇在内的PLO的临床特征和疾病严重程度的潜在危险因素,肝素暴露与乳糜泻。
目的:妊娠和哺乳相关性骨质疏松症(PLO)是一种罕见的早发性骨质疏松症,年轻女性出现骨折,通常是多发性椎骨骨折,在怀孕后期或哺乳期。关于病因的信息很少,临床特征,疾病严重程度的危险因素和预测因素。
方法:招募PLO患者完成匿名在线问卷。疾病严重程度定义为第一次妊娠期间或之后与骨折相关的骨折总数。分析相关疾病严重程度与潜在预测因素,包括疾病/状况或药物暴露。
结果:在2018年5月29日至2022年1月12日之间收到了177项完成的调查。初次PLO骨折事件的平均年龄为32±5岁。大多数是初产妇,单胎妊娠,哺乳期骨折79%。受试者报告总PLO骨折4.7±2.7,48%报告≥5处骨折。椎体骨折,由164/177名响应者报告(93%),是最常见的骨折类型。最常报告的疾病和药物包括维生素D缺乏,与怀孕无关的闭经,肾结石,乳糜泻(CD),口服类固醇,怀孕期间的肝素产品和孕激素仅在怀孕后避孕。妊娠期间的CD和肝素暴露与疾病严重程度显着相关。
结论:这是迄今为止以PLO的临床特征为特征的最大研究。大量的参与者和广泛的临床和骨折特征查询已经产生了关于PLO特征和其严重程度的潜在危险因素的新信息。包括原语奇偶校验,暴露于肝素和CD。这些发现提供了重要的初步数据,可以帮助针对未来的机械调查。
Pregnancy and lactation associated osteoporosis is a rare and often severe osteoporosis presentation. Little information is available about etiology, clinical characteristics, risk factors and predictors of severity. Using an anonymized questionnaire, we defined clinical characteristics and potential risk factors for disease severity in PLO including primiparity, heparin exposure and celiac disease.
OBJECTIVE: Pregnancy and lactation associated osteoporosis (PLO) is a rare form of early-onset osteoporosis in which young women present with fractures, usually multiple vertebral fractures, during late pregnancy or lactation. Little information is available about etiology, clinical characteristics, risk factors and predictors of disease severity.
METHODS: PLO patients were recruited to complete an anonymized online questionnaire. Disease severity was defined as total number of fractures during or after the first pregnancy associated with a fracture(s). Analyses related disease severity to potential predictors including diseases/conditions or medication exposures.
RESULTS: 177 completed surveys were received between 5/29/2018 and 1/12/2022. Average age at initial PLO fracture event was 32 ± 5 years. The majority were primiparous with singleton pregnancy and 79% fractured during lactation. Subjects reported 4.7 ± 2.7 total PLO fractures, with 48% reporting ≥ 5 fractures. Vertebral fractures, reported by 164/177 responders (93%), were the most common fracture type. Conditions and medications most commonly reported included vitamin D deficiency, amenorrhea unrelated to pregnancy, nephrolithiasis, celiac disease (CD), oral steroid use, heparin products during pregnancy and progestin only contraceptive after pregnancy. CD and heparins exposure during pregnancy were significantly related to disease severity.
CONCLUSIONS: This is the largest study characterizing clinical features of PLO to date. The large number of participants and broad range of clinical and fracture characteristics queried has yielded novel information on the characteristics of PLO and potential risk factors for its severity, including primiparity, exposure to heparin and CD. These findings provide important preliminary data that can help target future mechanistic investigations.