Schwangerschaftsassoziierte Osteoporose

Every woman underlies a risk of 30% to get osteoporosis in her life. In most of the cases postmenopausal osteoporosis is the dealing cause. This systemic skeletal disease can also occur in the course of pregnancy or lactation which is a rare phenomenon known for about 50 years. In that period 80-100 cases of the so-called pregnancy-associated osteoporosis were published. An exact prevalence could so far not be registered. Most often the disease occurs in the third trimester of pregnancy or after delivery with back pain and immobility. Primiparae between 25 und 30 years old are often affected. The young women can be heavily impaired in her physical und mental health what causes problems in the mother-child-relationship, the family planning and also in the working environment. In most of the cases a cause for the development of a pregnancy-associated osteoporosis could not be assessed. It remains uncertain if the pregnancy itself is the underlying cause or if a low bone mass in the prepregnancy is the promotive factor in this development. With a high probability a mulifactorial pathogenesis is concerned. To overview the prevalence of the pregnancy-associated osteoporosis in Germany and to work out its risk factors the german center of pregnancy-associated osteoporosis („Deutsches Referenzzentrum für schwangerschaftsassoziierte Osteoporose”) was installed. Affected young women were invited to get in contact with the center. During the conversations by telephone a questionnaire was filled in. The statistical evaluations of the information made by these interviews are presented in this dissertation. 102 patients could be registered in the database. This represents the biggest collective worldwide of women with pregnancy-associated osteoporosis. Additionally to 71 of the patients 71 controls could be interviewed. This study management of matched pairs allowed delivering a statistical analysis of the differences and similarities between the two groups: The patients were thinner than the women in the control group. Also the subjective perception of the weight seemed to play an important role: the patients often considered her weight as too low, but in pregnancy they put on weight less than 12% than the women in the control group. These findings demonstrate a disordered awareness of the own body and explain a probable false nutritional behaviour. Furthermore interesting facts are the high rate of lactose intolerance as well as a higher incidence of dental problems in the patient group. They also showed a lower physical activity in their childhood and adolescence. In their gynecological history a longer period of amenorrhea became evident. The pregnancy-associated osteoporosis is a complex and in its pathophysiology not entirely defined disease. In the present there exist no specific strategies concerning the diagnostical procedure, the therapeutic possibilities and the prevention of this disease. This paper provides the hypothesis that an important number of unreported cases of pregnancy-associated osteoporosis exits and that the clinical appearance can be underestimated. The characteristics which were found can be valued as risk factors for the development of osteoporosis during pregnancy. The information can be used in the prevention management for identification and classification of pregnant women who are at a risk for developing an osteoporosis during pregancy or lactation.