Pregnancy‐Related Bone Mineral and Microarchitecture Changes in Women Aged 30 to 45 Years

Published on Jul 1, 2020in Journal of Bone and Mineral Research5.854
· DOI :10.1002/JBMR.3998
Mícheál Ó Breasail1
Estimated H-index: 1
(University of Cambridge),
Ann Prentice2
Estimated H-index: 2
(University of Cambridge)
+ 0 AuthorsKate A Ward37
Estimated H-index: 37
(University of Cambridge)
At birth the neonatal skeleton contains 20-30 g Ca, it is hypothesized maternal bone mineral may be mobilized to support fetal skeletal development, though evidence of pregnancy-induced mineral mobilization is limited. We recruited healthy pregnant (n = 53) and non-pregnant non-lactating (NPNL, n = 37) women aged 30-45 years (mean 35.4 +/- 3.8 years) and obtained peripheral quantitative computed tomography (pQCT) and high-resolution pQCT (HR-pQCT) scans from the tibia and radius at 14-16 and 34-36 weeks pregnancy, with a similar scan interval for NPNL. Multiple linear regression models were used to assess group differences in change between baseline and follow-up; differences are expressed as standard deviation scores (SDS) +/- SEM. Decreases in vBMD outcomes were found in both groups, however, pregnancy-related decreases for pQCT total and trabecular vBMD were - 0.65 +/- 0.22 SDS and - 0.50 +/- 0.23 SDS greater (p < 0.05). HR-pQCT total and cortical vBMD decreased compared to NPNL by -0.49 +/- 0.24 SDS and - 0.67 +/- 0.23 SDS respectively; trabecular vBMD decreased in both groups to a similar magnitude. Pregnancy-related changes in bone microarchitecture significantly exceeded NPNL change for trabecular number 0.47 +/- 0.23 SDS, trabecular separation -0.54 +/- 0.24 SDS, cortical thickness - 1.01 +/- 0.21 SDS, and cortical perimeter 0.78 +/- 0.23 SDS. At the proximal radius, cortical vBMD and endosteal circumference increased by 0.50 +/- 0.23 SDS and 0.46 +/- 0.23 SDS respectively compared to NPNL while cortical thickness decreased -0.50 +/- 0.22 SDS. Pregnancy-related decreases in total and compartment-specific vBMD exceed age-related change at the distal tibia. Changes at the radius were only evident with pQCT at the cortical-rich proximal site and suggest endosteal resorption. Although the magnitude of these pregnancy-related changes in the appendicular skeleton are small, if they reflect global changes across the skeleton at large they may contribute substantially to the Ca requirements of the fetus. This article is protected by copyright. All rights reserved.
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