Pregnancy and lactation-associated osteoporosis: insights from an online self-reported patient survey.

UNLABELLED: Pregnancy and lactation-associated osteoporosis (PLO) is a rare yet debilitating cause of vertebral fractures in young women. Despite its significant clinical impact, PLO remains underdiagnosed, and data on its risk factors and management are limited. In our cohort, vitamin D deficiency, heparin exposure and a family history of osteoporosis emerged as key risk factors. Among anti-osteoporotic medications, teriparatide was the most commonly prescribed, followed by denosumab, alendronate and others.

PURPOSE: This study aimed to characterize the clinical features of women with PLO and to identify key risk factors using self-reported data from an online patient support group.

METHODS

A cross-sectional study was conducted among 52 women diagnosed with PLO, identified via a patient support group on WhatsApp. Data were collected through an online survey assessing demographics, fracture characteristics, bone mineral density (BMD), treatment approaches, and potential risk factors. Participants were stratified into two groups (with vs. without fractures) for comparative analysis.

RESULTS

The mean age of participants was 33.8 ± 4.7 years. Fractures occurred in 78.8% of participants, predominantly involving the spine (90.2%). The mean T-scores were -2.9 ± 0.8 at the spine and -1.8 ± 1.3 at the femoral neck. Key reported risk factors were vitamin D deficiency, heparin use during pregnancy, and a family history of osteoporosis. Women with fractures reported significantly higher levels of physical activity during pregnancy (p = 0.026). Anti-osteoporotic medications were used by 58% of participants, and teriparatide was the most frequently prescribed agent (44.8%).

CONCLUSION

PLO is an underrecognized and disabling complication of pregnancy, most often resulting in vertebral fractures. Greater clinical awareness, targeted screening, and individualized management are crucial to reduce preventable maternal morbidity in high-risk women.