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

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

At birth, the neonatal skeleton contains 20 to 30 g calcium (Ca). It is hypothesized maternal bone mineral may be mobilized to support fetal skeletal development, although 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 to 45 years (mean age 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 to 16 and 34 to 36 weeks of 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 volumetric bone mineral density (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 <.05). HR-pQCT total and cortical vBMD decreased compared with 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 with NPNL, whereas 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.

AGING, ANALYSIS/QUANTITATION OF BONE, BONE QCT/μCT, EPIDEMIOLOGY, GENERAL POPULATION STUDIES
0884-0431
1253-1262
Breasail, Micheal O
91913ba1-a694-4365-80f0-dc253cc025c2
Prentice, Ann
675810ad-8022-453c-b3a3-8afff0e1a920
Ward, Kathryn
39bd4db1-c948-4e32-930e-7bec8deb54c7
Breasail, Micheal O
91913ba1-a694-4365-80f0-dc253cc025c2
Prentice, Ann
675810ad-8022-453c-b3a3-8afff0e1a920
Ward, Kathryn
39bd4db1-c948-4e32-930e-7bec8deb54c7

Breasail, Micheal O, Prentice, Ann and Ward, Kathryn (2020) Pregnancy-Related Bone Mineral and Microarchitecture Changes in Women Aged 30 to 45 Years. Journal of Bone and Mineral Research, 35 (7), 1253-1262. (doi:10.1002/jbmr.3998).

Record type: Article

Abstract

At birth, the neonatal skeleton contains 20 to 30 g calcium (Ca). It is hypothesized maternal bone mineral may be mobilized to support fetal skeletal development, although 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 to 45 years (mean age 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 to 16 and 34 to 36 weeks of 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 volumetric bone mineral density (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 <.05). HR-pQCT total and cortical vBMD decreased compared with 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 with NPNL, whereas 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.

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Pregnancy-related bone mineral and microarchitecture changes in women aged 30-45 years - Accepted Manuscript
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Accepted/In Press date: 13 February 2020
e-pub ahead of print date: 2 March 2020
Published date: 1 July 2020
Additional Information: Funding Information: The authors acknowledge the contribution of the study participants; Jenny Woolston of MRC Elsie Widdowson Laboratory, who helped with ethical application and study setup; Drs Catherine Aiken and Jeremy Brockelsby for local oversight; Julie Holgate and Sue Tiplady of the Rosie Hospital (Cambridge University Hospital) for study recruitment; Darren Cole of MRC Elsie Widdowson Laboratory for database creation and pQCT cleaning tool design; and Millie Parsons of MRC Lifecourse Epidemiology Unit for statistical advice. This research was conducted under the Medical Research Council Program Grant Code U105960371. Authors' roles: Study design: MOB, KW, and AP. Study conduct: MOB and KW. Data collection: MOB. Data analysis: MOB and KW. Data interpretation: MOB, KW, and AP. Drafting manuscript: MOB, KW, and AP. Revising manuscript content: MOB, KW, and AP. Approving final version of manuscript: MOB, KW, and AP. MOB takes responsibility for the integrity of the data analysis. Publisher Copyright: © 2020 Crown copyright. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR). This article is published with the permission of the Controller of HMSO and the Queen's Printer for Scotland.
Keywords: AGING, ANALYSIS/QUANTITATION OF BONE, BONE QCT/μCT, EPIDEMIOLOGY, GENERAL POPULATION STUDIES

Identifiers

Local EPrints ID: 438480
URI: http://eprints.soton.ac.uk/id/eprint/438480
ISSN: 0884-0431
PURE UUID: 6dda8014-7710-4a41-b11a-871ed1e760e0
ORCID for Kathryn Ward: ORCID iD orcid.org/0000-0001-7034-6750

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Date deposited: 11 Mar 2020 17:30
Last modified: 16 Sep 2022 04:01

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Contributors

Author: Micheal O Breasail
Author: Ann Prentice
Author: Kathryn Ward ORCID iD

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