Pregnancy- and lactation-associated osteoporosis: A report of six cases

Abstract

Abstract Objective To illustrate the clinical characteristics of pregnancy- and lactation-associated osteoporosis (PLO) by retrospectively analyzing six cases of PLO. Methods Six cases of PLO diagnosed in our Endocrinology and Orthopedics Departments from January 2018 to June 2020 were retrospectively studied. The baseline characteristics, clinical features, laboratory findings, radiological manifestations and follow-up outcomes were analyzed and compared with previous reports. Results The mean age of the six patients was 33.5 years old (range 30-36 years) with a mean height of 163 cm (range 151-171 cm), mean weight of 56.2 kg (range 47-73 kg) and mean body mass index (BMI) of 21.3 kg/m2 (range 17.4-28.5 kg/m2). All enrolled patients complained of low back pain, with a mean visual analogue scale (VAS) score of 7.0 points (4-10). The mean bone mineral density (BMD), as assessed by the Z-score obtained from the dual-energy X-ray absorptiometry measurement, was -2.90 (range -4.37- -1.34). All six patients underwent magnetic resonance imaging (MRI) scans and vertebral compressive fractures were detected in four patients. The main feature of MRI images of the patients was the appearance of strip-shaped abnormal signal area under the upper endplate of the vertebrae, with low T1 phase signal and high T2 fat-suppressed phase signal. The fractures mainly affected the thoracolumbar regions. Fractures in four patients were all multiple vertebral fractures, with at least two and at most nine vertebral fractures. All six patients received conservative treatment, and no surgical intervention. After a mean follow-up of 27.3 months (range 24-31 months), the symptoms of the six patients were significantly relieved, although four patients still had low back pain to varying degrees. Conclusion PLO tends to occur in older and thinner women with clinical manifestations varying in severity. MRI often reveals multiple vertebral compressive fractures in patients with PLO. PLO has good prognosis with conservative treatment, but complete relief may take a long time.