Elizabeth Orhadje, Navnit Makaram, Kathryn Berg, Barbara Hauser, Stuart H Ralston
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Analysis of treatment response was inconclusive due to limited availability of data.</p><p><strong>Introduction: </strong>Pregnancy-associated osteoporosis (PAO) is a rare disorder most often presenting with vertebral fractures during pregnancy or postpartum.</p><p><strong>Aims: </strong>This meta-analysis aimed to evaluate the presenting features of PAO, its risk factors and the effectiveness of various treatments at improving bone mineral density (BMD) and preventing further fractures.</p><p><strong>Methods: </strong>A systematic search of PubMed, EMBASE and Web of Science identified 35 studies comprising 943 cases of PAO. A meta-analysis was conducted to evaluate the effect of treatment on change in BMD at the lumbar spine, femoral neck and total hip.</p><p><strong>Results: </strong>Vertebral fractures and back pain occurred in 89.2% and 90.2% of cases, respectively. The diagnosis was predominantly made postpartum. The most common risk factor was a family history of osteoporosis (40.5%). Calcium and vitamin D supplements (31.8%) and teriparatide (30.8%) were the most commonly used treatments. The meta-analysis of BMD response was inconclusive due to limited availability of data. The BMD change at the lumbar spine was greater with teriparatide compared with calcium/vitamin D and bisphosphonates but this was based on only two studies. There was no difference in BMD response at the femoral neck. Recurrent fractures were reported in 12.9% with no difference between treatment groups.</p><p><strong>Conclusion: </strong>While this review can assist clinicians with the diagnosis and management of PAO, it highlights some key knowledge gaps that may inform conduct of a Delphi process on the diagnosis and management of this disorder, pending conduct of randomised controlled trials.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"981-993"},"PeriodicalIF":4.2000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Clinical presentation, risk factors and management of pregnancy-associated osteoporosis: a systematic review and meta-analysis.\",\"authors\":\"Elizabeth Orhadje, Navnit Makaram, Kathryn Berg, Barbara Hauser, Stuart H Ralston\",\"doi\":\"10.1007/s00198-025-07479-0\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>A systematic review and meta-analysis of the presentation, risk factors and treatment response of pregnancy-associated osteoporosis was conducted involving 35 studies and 943 patients. Vertebral fractures, back pain and family history of osteoporosis were common features. Analysis of treatment response was inconclusive due to limited availability of data.</p><p><strong>Introduction: </strong>Pregnancy-associated osteoporosis (PAO) is a rare disorder most often presenting with vertebral fractures during pregnancy or postpartum.</p><p><strong>Aims: </strong>This meta-analysis aimed to evaluate the presenting features of PAO, its risk factors and the effectiveness of various treatments at improving bone mineral density (BMD) and preventing further fractures.</p><p><strong>Methods: </strong>A systematic search of PubMed, EMBASE and Web of Science identified 35 studies comprising 943 cases of PAO. A meta-analysis was conducted to evaluate the effect of treatment on change in BMD at the lumbar spine, femoral neck and total hip.</p><p><strong>Results: </strong>Vertebral fractures and back pain occurred in 89.2% and 90.2% of cases, respectively. The diagnosis was predominantly made postpartum. The most common risk factor was a family history of osteoporosis (40.5%). Calcium and vitamin D supplements (31.8%) and teriparatide (30.8%) were the most commonly used treatments. The meta-analysis of BMD response was inconclusive due to limited availability of data. The BMD change at the lumbar spine was greater with teriparatide compared with calcium/vitamin D and bisphosphonates but this was based on only two studies. There was no difference in BMD response at the femoral neck. 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引用次数: 0
摘要
对妊娠相关性骨质疏松症的表现、危险因素和治疗反应进行了系统回顾和荟萃分析，涉及35项研究和943例患者。椎体骨折、背痛和骨质疏松家族史是常见的特征。由于数据有限，对治疗反应的分析尚无定论。妊娠相关性骨质疏松症（PAO）是一种罕见的疾病，最常见于妊娠或产后椎体骨折。目的：本荟萃分析旨在评估PAO的表现特征，其危险因素以及各种治疗方法在改善骨密度（BMD）和预防进一步骨折方面的有效性。方法：系统检索PubMed、EMBASE和Web of Science共35篇研究，943例PAO病例。我们进行了一项荟萃分析来评估治疗对腰椎、股骨颈和全髋关节骨密度变化的影响。结果：椎体骨折和背部疼痛发生率分别为89.2%和90.2%。诊断主要是在产后做出的。最常见的危险因素是骨质疏松家族史（40.5%）。钙和维生素D补充剂（31.8%）和特立帕肽（30.8%）是最常用的治疗方法。由于数据有限，BMD反应的荟萃分析尚无定论。与钙/维生素D和双膦酸盐相比，特立帕肽对腰椎骨密度的改变更大，但这仅基于两项研究。股骨颈的骨密度反应没有差异。复发性骨折发生率为12.9%，两组间无差异。结论：虽然这篇综述可以帮助临床医生诊断和管理PAO，但它强调了一些关键的知识空白，这些空白可能会对这种疾病的诊断和管理进行德尔菲过程，等待随机对照试验的进行。
Clinical presentation, risk factors and management of pregnancy-associated osteoporosis: a systematic review and meta-analysis.
A systematic review and meta-analysis of the presentation, risk factors and treatment response of pregnancy-associated osteoporosis was conducted involving 35 studies and 943 patients. Vertebral fractures, back pain and family history of osteoporosis were common features. Analysis of treatment response was inconclusive due to limited availability of data.
Introduction: Pregnancy-associated osteoporosis (PAO) is a rare disorder most often presenting with vertebral fractures during pregnancy or postpartum.
Aims: This meta-analysis aimed to evaluate the presenting features of PAO, its risk factors and the effectiveness of various treatments at improving bone mineral density (BMD) and preventing further fractures.
Methods: A systematic search of PubMed, EMBASE and Web of Science identified 35 studies comprising 943 cases of PAO. A meta-analysis was conducted to evaluate the effect of treatment on change in BMD at the lumbar spine, femoral neck and total hip.
Results: Vertebral fractures and back pain occurred in 89.2% and 90.2% of cases, respectively. The diagnosis was predominantly made postpartum. The most common risk factor was a family history of osteoporosis (40.5%). Calcium and vitamin D supplements (31.8%) and teriparatide (30.8%) were the most commonly used treatments. The meta-analysis of BMD response was inconclusive due to limited availability of data. The BMD change at the lumbar spine was greater with teriparatide compared with calcium/vitamin D and bisphosphonates but this was based on only two studies. There was no difference in BMD response at the femoral neck. Recurrent fractures were reported in 12.9% with no difference between treatment groups.
Conclusion: While this review can assist clinicians with the diagnosis and management of PAO, it highlights some key knowledge gaps that may inform conduct of a Delphi process on the diagnosis and management of this disorder, pending conduct of randomised controlled trials.
期刊介绍：
An international multi-disciplinary journal which is a joint initiative between the International Osteoporosis Foundation and the National Osteoporosis Foundation of the USA, Osteoporosis International provides a forum for the communication and exchange of current ideas concerning the diagnosis, prevention, treatment and management of osteoporosis and other metabolic bone diseases.
It publishes: original papers - reporting progress and results in all areas of osteoporosis and its related fields; review articles - reflecting the present state of knowledge in special areas of summarizing limited themes in which discussion has led to clearly defined conclusions; educational articles - giving information on the progress of a topic of particular interest; case reports - of uncommon or interesting presentations of the condition.
While focusing on clinical research, the Journal will also accept submissions on more basic aspects of research, where they are considered by the editors to be relevant to the human disease spectrum.
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