Last update Dec. 30, 2022

Pregnancy and Lactation-associated Osteoporosis (PLO)

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Unsafe. Moderate/severe adverse effects. Compatible under certain circumstances. Follow-up recommended. Use safer alternative or discontinue breastfeeding from 5 to 7 T ½ . Read Commentary.

Pregnancy and Lactation-associated Osteoporosis (PLO) is a rare, severe and early form of osteoporosis in which young women present with severe back pain with fractures, usually multiple vertebral fractures, late in pregnancy or in the first months of breastfeelife. lactation. The pathogenesis of PLO remains unclear due to its rarity. (Condon 2022, Lujano 2022, Bai 2021, Jun 2020, Jia 2020, Cohen 2019, Hardcastle 2019)

The treatments used are calcium and vitamin D  (Condon 2022, Bai 2021, Jun 2020, JIa 2020, Cerit 2020, Zhang  2017), bisphosphonates such as alendronate or risedronate( Bai 2021, Jia 2020, Hardcastle 2019, Li 2018) or teriparatide and/or denosumab. (Condon 2022, Cerit 2020, Ijuin 2017, Choe 2012)

Most authors recommend the suppression of lactation. (Bai 2021, Jun 2020, Jia 2020, Cerit 2020, Ijuin 2017, Choe 2012)

Not to be confused with normal osteoporosis that can appear during pregnancy or lactation


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Pregnancy and Lactation-associated Osteoporosis (PLO) belongs to this group or family:

References

  1. Condon SB, Veitch M. The experience of pregnancy associated osteoporosis: An international survey with implications for midwifery care. Midwifery. 2022 Dec;115:103468. Consulted on Dec. 30, 2022 Abstract Full text (link to original source)
  2. Lujano-Negrete AY, Rodríguez-Ruiz MC, Skinner-Taylor CM, Perez-Barbosa L, Cardenas de la Garza JA, García-Hernández PA, Espinosa-Banuelos LG, Gutierrez-Leal LF, Jezzini-Martínez S, Galarza-Delgado DÁ. Bone metabolism and osteoporosis during pregnancy and lactation. Arch Osteoporos. 2022 Feb 19;17(1):36. Abstract
  3. Bai X, Wang G, Xu G, Wang B. Malleolar fracture in pregnancy and lactation-associated osteoporosis: a case report and literature review. Arch Osteoporos. 2021 Feb 21;16(1):36. Abstract
  4. Jun Jie Z, Ai G, Baojun W, Liang Z. Intertrochanteric fracture in pregnancy- and lactation-associated osteoporosis. J Int Med Res. 2020 Feb;48(2):300060519858013. Abstract Full text (link to original source)
  5. Jia P, Wang R, Yuan J, Chen H, Bao L, Feng F, Tang H. A case of pregnancy and lactation-associated osteoporosis and a review of the literature. Arch Osteoporos. 2020 Jun 25;15(1):94. Abstract
  6. Cerit ET, Cerit M. A case of pregnancy and lactation associated osteoporosis in the third pregnancy; robust response to teriparatide despite delayed administration. Bone Rep. 2020 Aug 13;13:100706. Abstract Full text (link to original source)
  7. Hardcastle SA, Yahya F, Bhalla AK. Pregnancy-associated osteoporosis: a UK case series and literature review. Osteoporos Int. 2019 May;30(5):939-948. Abstract
  8. Cohen A, Kamanda-Kosseh M, Dempster DW, Zhou H, Müller R, Goff E, Colon I, Bucovsky M, Stubby J, Nickolas TL, Stein EM, Recker RR, Lappe JM, Shane E. Women With Pregnancy and Lactation-Associated Osteoporosis (PLO) Have Low Bone Remodeling Rates at the Tissue Level. J Bone Miner Res. 2019 Sep;34(9):1552-1561. Abstract Full text (link to original source)
  9. Li LJ, Zhang J, Gao P, Lv F, Song YW, Chang XY, Zhao DC, Wang O, Jiang Y, Xing XP, Xia WB, Li M. Clinical characteristics and bisphosphonates treatment of rare pregnancy- and lactation-associated osteoporosis. Clin Rheumatol. 2018 Nov;37(11):3141-3150. Abstract
  10. Ijuin A, Yoshikata H, Asano R, Tsuburai T, Kikuchi R, Sakakibara H. Teriparatide and denosumab treatment for pregnancy and lactation-associated osteoporosis with multiple vertebral fractures: A case study. Taiwan J Obstet Gynecol. 2017 Dec;56(6):863-866. Abstract Full text (link to original source)
  11. Zhang M, Chen P, Li B, Du J, Pan T, Chen J. Approach to the patient with pregnancy and lactation-associated osteoporosis: A case report and a review of the literature. Medicine (Baltimore). 2017 Nov;96(46):e8671. Abstract Full text (link to original source)
  12. Choe EY, Song JE, Park KH, Seok H, Lee EJ, Lim SK, Rhee Y. Effect of teriparatide on pregnancy and lactation-associated osteoporosis with multiple vertebral fractures. J Bone Miner Metab. 2012 Sep;30(5):596-601. Abstract

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